This Article Full Text Full Text (PDF) All Versions of this Article: 117/20/2583    most recent CIRCULATIONAHA.107.716712v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cha, Y.-M. Articles by Packer, D. L. Search for Related Content PubMed PubMed Citation Articles by Cha, Y.-M. Articles by Packer, D. L. Related Collections Obesity Ablation/ICD/surgery Arrhythmias, clinical electrophysiology, drugs Related Article

(Circulation. 2008;117:2583-2590.)
© 2008 American Heart Association, Inc.

Arrhythmia/Electrophysiology

Catheter Ablation for Atrial Fibrillation in Patients With Obesity

Yong-Mei Cha, MD; Paul A. Friedman, MD; Samuel J. Asirvatham, MD; Win-Kuang Shen, MD; Thomas M. Munger, MD; Robert F. Rea, MD; Peter A. Brady, MD; Arshad Jahangir, MD; Kristi H. Monahan, RN; David O. Hodge, MS; Ryan A. Meverden, BS; Bernard J. Gersh, MB, ChB; Stephen C. Hammill, MD; Douglas L. Packer, MD

From the Divisions of Cardiovascular Diseases (Y.-M.C., P.A.F., S.J.A., W.-K.S., T.M.M., R.F.R., P.A.B., A.J., K.H.M., B.J.G., S.C.H., D.L.P.) and Biostatistics (D.O.H., R.A.M.), Mayo Clinic, Rochester, Minn.

Reprint requests to Yong-Mei Cha, MD, Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail ycha{at}mayo.edu

Received May 21, 2007; accepted March 10, 2008.

Background— Obesity is a risk factor for atrial fibrillation and other cardiovascular conditions. Our objective was to determine whether catheter-based ablation effectively treated atrial fibrillation in obese patients.

Methods and Results— Five hundred twenty-three consecutive patients with symptomatic, medication-refractory atrial fibrillation underwent catheter ablation. Patients were grouped by body mass index (lean, <25 kg/m²; overweight, 25 to 29.9 kg/m²; obese, 30 kg/m²). Outcome and quality of life were measured with a general health survey (Medical Outcomes Study 36-item Short-Form General Health Survey [SF-36]); patients were assessed before ablation and at 3 and 12 months after the procedure. Two hundred twenty-eight study patients (44%) were overweight, and 201 (38%) were obese. Twelve months after curative ablation, 72% of patients were free of atrial fibrillation without the use of antiarrhythmic agents; 84% were arrhythmia free when those receiving medication were included. Atrial fibrillation was eliminated in 75%, 72%, and 70% of the lean, overweight, and obese patients, respectively, at 12 months (P=0.41, trend test). SF-36 scores were lower for patients with higher body mass index (P<0.05) at baseline. SF-36 scores improved in every functional domain for all body mass index groups after ablation. The mean SF-36 total physical score increased from 59±20 at baseline to 77±19 in 12 months (P<0.001). The total mental health score improved from 66±18 to 79±16 in 12 months (P<0.001).

Conclusions— Catheter ablation of atrial fibrillation was effective in obese patients. Coexistence of atrial fibrillation and obesity indicated lower SF-36 scores, but the improvement in quality of life was consistent across all body mass index categories.

---

 

CLINICAL PERSPECTIVE

Related Article:

Clinical Summaries
Circulation 2008 117: 2567-2569. [Extract] [Full Text]

This article has been cited by other articles:

				C. Scharf, L. Boersma, W. Davies, P. Kanagaratnam, N. S. Peters, V. Paul, E. Rowland, A. Grace, S. Fynn, L. Dang, et al. Ablation of Persistent Atrial Fibrillation Using Multielectrode Catheters and Duty-Cycled Radiofrequency Energy J. Am. Coll. Cardiol., October 6, 2009; 54(15): 1450 - 1456. [Abstract] [Full Text] [PDF]

				T. Terasawa, E. M. Balk, M. Chung, A. C. Garlitski, A. A. Alsheikh-Ali, J. Lau, and S. Ip Systematic Review: Comparative Effectiveness of Radiofrequency Catheter Ablation for Atrial Fibrillation Ann Intern Med, August 4, 2009; 151(3): 191 - 202. [Abstract] [Full Text] [PDF]

				K. Chilukuri, D. Dalal, J. E. Marine, D. Scherr, C. A. Henrikson, A. Cheng, S. Nazarian, D. Spragg, R. Berger, and H. Calkins Predictive value of obstructive sleep apnoea assessed by the Berlin Questionnaire for outcomes after the catheter ablation of atrial fibrillation Europace, July 1, 2009; 11(7): 896 - 901. [Abstract] [Full Text] [PDF]