Dan Roden
Faculty Member
Last active: 2/8/2016

Relation of morbid obesity and female gender to risk of procedural complications in patients undergoing atrial fibrillation ablation.

Shoemaker MB, Muhammad R, Farrell M, Parvez B, White BW, Streur M, Stubblefield T, Rytlewski J, Parvathaneni S, Nagarakanti R, Roden DM, Saavedra P, Ellis C, Whalen SP, Darbar D
Am J Cardiol. 2013 111 (3): 368-73

PMID: 23168290 · PMCID: PMC3546280 · DOI:10.1016/j.amjcard.2012.10.013

Obese patients with atrial fibrillation (AF) are frequently treated with AF ablation. We sought to examine whether a body mass index (BMI) threshold exists beyond which the odds of experiencing a complication from AF ablation increases. 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 was defined as a BMI >40 kg/m(2) and examined in multivariable analysis. A total of 35 complications (6.8%) occurred in 512 ablations. Morbidly obese patients experienced a greater rate of complications (6 of 42, 14.3%) than the nonmorbidly obese (29 of 470, 6.2%; p = 0.046). Using a discrete BMI cutoff, the odds of complications increased 3.1-fold in those with morbid obesity (odds ratio [OR] 3.1, 95% confidence interval [CI] 1.1 to 8.4, p = 0.03) and 2.1-fold for female gender (OR 2.1, 95% CI 1.04 to 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 to 1.11, p = 0.05), and the increase for female gender was 2.2-fold (OR 2.2, 95% CI 1.1 to 4.6, p = 0.03). In conclusion, morbid obesity represents a BMI threshold above which the odds of complications with AF ablation increase significantly. The increase in complications appears to be driven primarily by events in women, suggesting that morbidly obese women are a special population when considering AF ablation.

Copyright © 2013 Elsevier Inc. All rights reserved.

MeSH Terms (21)

Atrial Fibrillation Body Mass Index Catheter Ablation Confidence Intervals Electrocardiography Female Follow-Up Studies Humans Incidence Male Middle Aged Obesity, Morbid Odds Ratio Postoperative Complications Prospective Studies Risk Assessment Risk Factors Sex Factors Survival Rate Tennessee Treatment Outcome

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