Risk for atrial fibrillation recurrence increases with body weight

Rates of atrial fibrillation (AF) recurrence following ablation increase incrementally according to body mass index, both in short- and long-term follow-up, according to a study presented at the annual meeting of the European Heart Rhythm Association, held from April 3 to 5 in Copenhagen, Denmark.

Jacob Toennesen, M.B.B.S., from Gentofte University Hospital in Denmark, and colleagues used Danish registries to identify all adult patients (9,229 individuals) who underwent first-time AF ablation from 2010 through 2018. Relative rates of AF recurrence were examined by body weight.

The researchers found that the median age at first-time AF ablation was lower in the morbidly obese group (60 years) than in the normal-weight group (64 years). The number of patients with a CHA₂DS₂VASc score ≥2 was higher in the morbidly obese group (65 percent) than in the normal-weight group (48 percent). Both at one-year and five-year follow-up, the risk for recurrent AF increased incrementally and significantly in overweight groups versus normal-weight patients.

"The strength of association between high body mass index and repeat atrial fibrillation after ablation was comparable to the influence of well-known factors like heart failure, chronic obstructive pulmonary disease, and hypertension which are typically treated in these patients," Toennesen said in a statement. "Our study suggests that overweight patients should be advised to lose weight before the intervention to improve the likelihood of being free of the arrhythmia afterwards."