Impact of abdominal obesity on outcomes of catheter ablation in Korean patients with atrial fibrillation



Ding, Wern Yew ORCID: 0000-0003-3596-6545, Yang, Pil-Sung, Jang, Eunsun, Gupta, Dhiraj, Sung, Jung-Hoon, Joung, Boyoung and Lip, Gregory YH ORCID: 0000-0002-7566-1626
(2021) Impact of abdominal obesity on outcomes of catheter ablation in Korean patients with atrial fibrillation. INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, 75 (10). e14696-.

Access the full-text of this item by clicking on the Open Access link.

Abstract

<h4>Background</h4>Effects of abdominal obesity on outcomes of atrial fibrillation (AF) ablation remains ill-defined. Here, we evaluated the impact of abdominal obesity on the long-term efficacy and safety of catheter AF ablation among Korean patients.<h4>Methods</h4>We utilised the Korean National Health Insurance Service database to identify patients who underwent AF ablation. Abdominal obesity was defined as waist circumference ≥90 cm (males) and ≥85 cm (females). The primary endpoint was AF recurrence and secondary endpoints were ischaemic stroke, intracranial haemorrhage and death. Additionally, safety endpoints of peri-procedural complications were studied.<h4>Results</h4>Among 5397 patients (median age 58 [IQR 51-65] years; 23.6% females), abdominal obesity was present in 1759 (32.6%). The rate of AF recurrence was not statistically different between the groups at 1-year (10.3 vs 8.7 events/100-PYs, P = .078), though abdominal obesity was associated with significantly higher rates of AF recurrence at 3-year (7.6 vs 6.3 events/100-PYs, P = .008) and 6-year (6.3 vs 5.2 events/100-PYs, P = .004) follow-ups. Kaplan-Meier survival analysis found significantly higher rates of AF recurrence in patients with obesity based on body mass index (BMI) and waist circumference (log-rank for trend P = .006). Using multivariable regression analysis, obesity by both BMI and waist circumference was an independent predictor for AF recurrence (HR 1.21 [95% CI, 1.05-1.40]), after accounting for other risk factors. There was a trend for increased rates of ischaemic stroke at 3-year and 6-year follow-ups in patients with abdominal obesity. Furthermore, this group of patients had a greater rate of intracranial haemorrhage. All-cause death was comparable between both groups. Total peri-procedural complications were not associated with abdominal obesity.<h4>Conclusion</h4>Abdominal obesity as indicated by waist circumference was associated with a greater burden of concomitant diseases and an independent risk factor for long-term redo AF intervention following catheter ablation but had no effects on total peri-procedural complications.

Item Type: Article
Uncontrolled Keywords: Humans, Brain Ischemia, Atrial Fibrillation, Obesity, Recurrence, Catheter Ablation, Treatment Outcome, Risk Factors, Middle Aged, Female, Male, Stroke, Obesity, Abdominal, Republic of Korea
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 24 Aug 2021 09:18
Last Modified: 18 Jan 2023 21:32
DOI: 10.1111/ijcp.14696
Open Access URL: http://doi.org/10.1111/ijcp.14696
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3134571