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 Henrikson, Alan Cheng, Saman Nazarian, Sunil Sinha, David Spragg, Ronald Berger, Hugh Calkins

Research output: Contribution to journalArticle

73 Citations (Scopus)

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 (2), overweight (≥25 and 2), 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 2010
Externally publishedYes

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Catheter Ablation
Obstructive Sleep Apnea
Atrial Fibrillation
Obesity
Prospective Studies
Body Mass Index
Berlin
Multivariate Analysis
Population

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

A prospective study evaluating the role of obesity and obstructive sleep apnea for outcomes after catheter ablation of atrial fibrillation. / Chilukuri, Karuna; Dalal, Darshan; Gadrey, Shrirang; Marine, Joseph E.; MacPherson, Edwin; Henrikson, Charles; Cheng, Alan; Nazarian, Saman; Sinha, Sunil; Spragg, David; Berger, Ronald; Calkins, Hugh.

In: Journal of Cardiovascular Electrophysiology, Vol. 21, No. 5, 05.2010, p. 521-525.

Research output: Contribution to journalArticle

Chilukuri, K, Dalal, D, Gadrey, S, Marine, JE, MacPherson, E, Henrikson, C, 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, vol. 21, no. 5, pp. 521-525. https://doi.org/10.1111/j.1540-8167.2009.01653.x
Chilukuri, Karuna ; Dalal, Darshan ; Gadrey, Shrirang ; Marine, Joseph E. ; MacPherson, Edwin ; Henrikson, Charles ; Cheng, Alan ; Nazarian, Saman ; Sinha, Sunil ; Spragg, David ; Berger, Ronald ; Calkins, Hugh. / A prospective study evaluating the role of obesity and obstructive sleep apnea for outcomes after catheter ablation of atrial fibrillation. In: Journal of Cardiovascular Electrophysiology. 2010 ; Vol. 21, No. 5. pp. 521-525.
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AU - Chilukuri, Karuna

AU - Dalal, Darshan

AU - Gadrey, Shrirang

AU - Marine, Joseph E.

AU - MacPherson, Edwin

AU - Henrikson, Charles

AU - Cheng, Alan

AU - Nazarian, Saman

AU - Sinha, Sunil

AU - Spragg, David

AU - Berger, Ronald

AU - Calkins, Hugh

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N2 - 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 (2), overweight (≥25 and 2), 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.

AB - 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 (2), overweight (≥25 and 2), 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.

KW - Atrial fibrillation

KW - Berlin questionnaire

KW - BMI

KW - Catheter ablation

KW - Obesity

KW - Obstructive sleep apnea

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