Cha YM et al. (2008) Catheter ablation for atrial fibrillation in patients with obesity. Circulation 117: 2583–2590

Most patients with atrial fibrillation (AF) are symptom-free after treatment by catheter ablation, yet it is unknown whether obese patients, who are at high risk of developing AF, benefit from this procedure to the same degree as nonobese patients. To investigate this issue, Cha et al. have determined the efficacy of catheter ablation in patients with a range of BMIs and have found that catheter ablation can effectively treat AF in obese individuals.

From November 2000 to June 2005, this prospective study enrolled 523 consecutive patients (18% of whom were lean [BMI <25 kg/m2], 44% were overweight [BMI 25.0–29.9 kg/m2] and 38% were obese [BMI ≥30 kg/m2]) who underwent radiofrequency catheter ablation at the Mayo Clinic, Rochester, MN. Of the patients who reached the 24-month follow-up, 74% (45 of 61), 73% (95 of 130) and 69% (72 of 105) of the lean, overweight and obese groups, respectively, were free of AF. There were no significant differences between the three groups in various ablation outcomes, although a weak trend toward reduced procedural efficacy was observed in the most obese patients.

Even though quality of life as measured by the Medical Outcomes Study 36-Item Short-Form General Health Survey (SF-36) was lower for the obese group than for the nonobese groups at baseline and at 3-month and 12-month follow-up, all three groups experienced a similar magnitude of improvement in SF-36 scores after surgery. In multivariate analysis, duration since diagnosis was the only factor associated with recurrence of the condition; BMI was not associated with poor outcome.