Abstract 16470: Morbid Obesity Increases the Risk of Procedural Complications in Patients Undergoing Atrial Fibrillation Ablation
Objectives: To evaluate the effect of morbid obesity on procedural complications associated with atrial fibrillation (AF) ablation.
Background: In the U.S., one third of adults are obese and obesity is a risk factor for the development of AF. Obese patients are frequently managed with AF ablation. We sought to examine whether there exists a body mass index (BMI) threshold beyond which odds of experiencing a complication from AF ablation increases.
Methods: All patients enrolled in the Vanderbilt AF Registry who underwent catheter-based AF ablation from May 1999 to February 2012 were included. Major complications were recorded. Morbid obesity defined as BMI >40 kg/m2 and BMI as a continuous variable were examined in multivariable analysis.
Results: Thirty-five complications (6.8%) occurred in 512 ablations. Morbidly obese patients experienced a higher rate of complications (6/42, 14.3%) than non-morbidly obese (BMI <40 kg/m2) patients (29/470, 6.2%) (P=0.046). In subgroup analysis, morbidly obese women trended toward a higher rate of complications than morbidly obese men (25% v. 8%, P=0.18) (Figure 1). Using a discrete BMI cut-off, the odds of complications increased 3.1-fold in those with morbid obesity (odds ratio [OR] 3.1, 95% Confidence Interval [CI] 1.1-8.4, P=0.03) and 2.1-fold by female gender (OR 2.1, 95% CI 1.04-4.38, P=0.04). With BMI as a continuous variable, the odds of complications increased by 5% per 1 unit increase in BMI (OR 1.05, 95% CI 1.0-1.11, P=0.05) and there was a 2.2-fold increase by female gender (OR 2.2, 95% CI 1.1-4.6, P=0.03).
Conclusions: Morbid obesity represents a BMI threshold above which the odds of complications with AF ablation significantly increases. The increase in complications appears to be driven primarily by events in women suggesting that morbidly obese women are a special population to consider when considering AF ablation.
- © 2012 by American Heart Association, Inc.