Association between postoperative obesity and recurrence after radiofrequency catheter ablation in patients with atrial fibrillation

Abstract

Aim: This study evaluated the association between postoperative body mass index (BMI) category at the 18 months postoperative follow-up and atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RCA).

Methods: From January to December 2023, 250 patients with AF who underwent single-operator RCA at the General Hospital of Northern Theater Command were enrolled. Baseline characteristics, BMI category at the 18 months postoperative follow-up (normal weight, overweight, obesity), and recurrence were collected. Kaplan-Meier survival analysis and multivariate Cox proportional hazards analysis were performed. The primary endpoint was AF recurrence confirmed by electrocardiogram (ECG) or Holter monitoring within 18 months.

Results: Among 110 patients with paroxysmal atrial fibrillation (PAF) and 140 patients with persistent atrial fibrillation (SAF). Multivariate Cox analysis showed that, among patients with PAF, postoperative obesity was associated with recurrence risk (P = 0.037). Among patients with SAF, postoperative overweight (P = 0.033), postoperative obesity (P = 0.003), and AF duration > 12 months (P = 0.002) were independently associated with recurrence. Kaplan-Meier analysis in patients with SAF showed 18 months recurrence-free rates of 88.2% for postoperative normal weight, 69.1% for postoperative overweight, and 55.3% for obesity (log-rank P = 0.006).

Conclusion: In this retrospective analysis, postoperative obesity was associated with a higher risk of recurrence after RCA for AF. Specifically, postoperative obesity was associated with recurrence in patients with PAF, whereas higher postoperative BMI grades and AF duration > 12 months were associated with recurrence in patients with SAF.

Keywords

Atrial fibrillation / radiofrequency catheter ablation / obesity / body mass index / recurrence

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