Catheter Ablation for Atrial Fibrillation in Patients with Obesity.

Abstract

Methods A cohort of 523 patients with symptomatic AF undergoing radiofrequency ablation at a single institution was included in this study. Body weight was determined and patients were stratified by body mass index into three groups: lean (BMI < 25 kg/m2), overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥ 30 kg/m2). Two techniques for atrial fibril lation ablation were employed: 298 patients underwent pulmonary vein ostial ablation with a 5mm tip ablation catheter and 222 patients underwent wide-area circumferential ablation outside the pulmonary vein ostia with an 8mm tip ablation catheter. Patients in this second group also underwent creation of linear lesions and ablation of focal triggers of AF identified during isoproterenol infusion. Patients were followed up with a 24-hour Holter monitor 3 months after the ablation. Follow-up after that time was performed by telephone, annual questionnaires, and with intermittent monitor ing, though the method and timing of monitoring is not well-described. Quality of life questionnaires were administered 3 and 12 months after ablation. Outcomes are reported at 12 and 24 months after ablation but Kaplan-Meier curves are not provided.