A prospective study evaluating the role of obesity and obstructive sleep apnea for outcomes after catheter ablation of atrial fibrillation

Karuna Chilukuri, Darshan Dalal, Shrirang Gadrey, Joseph E. Marine, Edwin MacPherson, Charles A. Henrikson, Alan Cheng, Saman Nazarian, Sunil Sinha, David Spragg, Ronald Berger, Hugh Calkins

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    75 Scopus citations

    Abstract

    Background: Obesity and obstructive sleep apnea (OSA) have a strong association with atrial fibrillation (AF). The purpose of this study was to prospectively determine the effects of obesity, assessed by the body mass index (BMI) and OSA on the efficacy of catheter ablation of AF. Methods: The patient population consisted of 109 patients (mean age: 60 ± 10 years, 79% male, 67% paroxysmal, mean BMI 28 ± 5 kg/m2) who underwent catheter ablation of AF. Based on BMI, patients were classified as normal (<25 kg/m2), overweight (≥25 and <30 kg/m2), or obese (≥30 kg/m2). OSA was assessed by the Berlin questionnaire. Clinical success was defined as at least 90% reduction in AF burden after 3-month blanking period. Mean duration of follow-up was 11 ± 4 months. Results: Of the 75 patients with clinical success, 25 (33%) had normal BMI, 29 (39%) were overweight, and 21 (28%) were obese. Among the 34 patients with failed outcome, 5 (15%) had normal BMI, 14 (41%) were overweight, and 15 (44%) were obese (P = 0.04). Twenty-eight of the 48 patients with OSA (58%) had clinical success as opposed to 47 of the 61 patients (77%) without OSA (P = 0.036). On multivariate analysis, only BMI emerged as an independent predictor of procedural failure ((OR 1.11, CI: 1.00-1.21, P = 0.03). Conclusions: The results of this prospective study show that obesity, a modifiable risk factor, is an independent predictor of procedural failure after catheter ablation of AF. Whether treating obesity may improve the results of catheter ablation of AF warrants further investigation.

    Original languageEnglish (US)
    Pages (from-to)521-525
    Number of pages5
    JournalJournal of cardiovascular electrophysiology
    Volume21
    Issue number5
    DOIs
    StatePublished - May 1 2010

    Keywords

    • Atrial fibrillation
    • BMI
    • Berlin questionnaire
    • Catheter ablation
    • Obesity
    • Obstructive sleep apnea

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

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  • Cite this

    Chilukuri, K., Dalal, D., Gadrey, S., Marine, J. E., MacPherson, E., Henrikson, C. A., Cheng, A., Nazarian, S., Sinha, S., Spragg, D., Berger, R., & Calkins, H. (2010). A prospective study evaluating the role of obesity and obstructive sleep apnea for outcomes after catheter ablation of atrial fibrillation. Journal of cardiovascular electrophysiology, 21(5), 521-525. https://doi.org/10.1111/j.1540-8167.2009.01653.x