PO-02-167 IMPACT OF OBESITY ON QUALITY OF LIFE AND CLINICAL OUTCOME IN PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING PRIMO PULMONARY VEIN ISOLATION

Abstract

Obesity is a major risk factor for the incidence and progression of atrial fibrillation (AF), negatively impacting AF ablation outcomes. Weight loss in obese patients prior to AF ablation may improve quality of life (QoL) and AF ablation success rates. To assess the impact of overweight and obesity on patient-reported outcomes (QoL scores) and clinical outcomes (AF recurrence) in patients undergoing index AF ablation procedure. This single-center cohort study retrospectively included 238 patients undergoing primo radiofrequency (RF) pulmonary vein isolation (PVI) who completed 1 year follow-up, including the Toronto AF Severity Scale (AFSS) questionnaire at baseline, 4-, and 12 months post-PVI for assessment of QoL (AF severity, AF burden, and global well-being). At baseline, patients were categorized by body mass index (BMI): normal (<25 kg/m2); overweight (≥25 - <30 kg/m2); and obese (≥30 kg/m2). AF recurrence was evaluated by either 24-h Holter monitoring, AliveCor KardiaMobile devices, or conventional electrocardiograms (ECG). Patients were divided based on BMI: 37.8% normal; 44.1% overweight; and 18.1% obese. Obese patients were more likely to be women (men 46.5%,p<0.01), and have diabetes mellitus (25.6%,p<0.01). AF recurrence rates detected during 12 months follow-up were similar among the three BMI groups: normal 27.8%, overweight 33.3%, and obese 30.2% (p=0.70). After AF ablation, all QoL scores in each BMI group improved, with no between-group differences (Table 1). Subgroup analysis showed significantly improved QoL scores in patients without AF recurrence independent of BMI category, however in patients with AF recurrence no significant improvement of AF severity and global well-being was found (Fig 1). Despite AF recurrence, self-reported AF burden significantly improved in the normal and overweight categories, but not in obese patients. A high BMI was not a major determinant of AF recurrence rates after a primo PVI. QoL after PVI was found to be determined by AF recurrence rather than BMI. This study suggests that obese patients might benefit from PVI to a similar extent compared to non-obese patients, though self-reported AF burden might differ between groups.