Impact of Body Mass Index on the Outcomes of Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation
Background: Atrial fibrillation (AF) is prevalent among obese patients, and cryoballoon ablation (CBA) is an effective strategy for the rhythm control of AF. The impact of body mass index (BMI) on the clinical outcomes of CBA for AF is not fully explored. Methods: 85 consecutive patients with paroxy...
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MDPI AG
2024-11-01
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| author | Konstantinos A. Papathanasiou Dimitrios A. Vrachatis Charalampos Kossyvakis Sotiria G. Giotaki Gerasimos Deftereos Maria Kousta Ioannis Anagnostopoulos Dimitrios Avramides George Giannopoulos Vaia Lambadiari Gerasimos Siasos Spyridon Deftereos |
| author_facet | Konstantinos A. Papathanasiou Dimitrios A. Vrachatis Charalampos Kossyvakis Sotiria G. Giotaki Gerasimos Deftereos Maria Kousta Ioannis Anagnostopoulos Dimitrios Avramides George Giannopoulos Vaia Lambadiari Gerasimos Siasos Spyridon Deftereos |
| author_sort | Konstantinos A. Papathanasiou |
| collection | DOAJ |
| description | Background: Atrial fibrillation (AF) is prevalent among obese patients, and cryoballoon ablation (CBA) is an effective strategy for the rhythm control of AF. The impact of body mass index (BMI) on the clinical outcomes of CBA for AF is not fully explored. Methods: 85 consecutive patients with paroxysmal AF were enrolled and were categorized into three groups as per their BMI: normal weight (BMI 18.5–25 kg/m<sup>2</sup>), overweight (BMI 25–30 kg/m<sup>2</sup>), and obese patients (BMI > 30 kg/m<sup>2</sup>). The primary study endpoint was a late (12 month) recurrence of AF. Early recurrence of AF, symptom improvement, and procedural outcomes were some key secondary outcomes. Results: 20 patients had normal weight, 35 were overweight, and 30 were obese. Obese patients featured a higher prevalence of diabetes mellitus, heavier exposure to smoking, and worse baseline symptoms (as assessed through EHRA class at admission and 12 months before CBA) compared to overweight and normal weight patients. Both late and early (<3 months) AF recurrence rates were comparable across the three groups. Of note, obese patients showed greater improvement in their symptoms post-CBA, defined as improvement by at least one EHRA class, compared to normal weight patients; this might be explained by improved diastolic function. Total procedure time and dose area product were significantly increased in obese patients. The multivariate logistic regression analysis indicated that early AF recurrence and the duration of hypertension are independent predictors of late AF recurrence. Conclusion: CBA is effective in overweight and obese patients with paroxysmal AF. Procedure time and radiation exposure are increased in obese patients undergoing CBA. |
| format | Article |
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| institution | Kabale University |
| issn | 2039-7283 |
| language | English |
| publishDate | 2024-11-01 |
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| series | Clinics and Practice |
| spelling | doaj-art-ec6b36fbccf24d84a090763b59a1e50a2024-12-27T14:18:33ZengMDPI AGClinics and Practice2039-72832024-11-011462463247410.3390/clinpract14060192Impact of Body Mass Index on the Outcomes of Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial FibrillationKonstantinos A. Papathanasiou0Dimitrios A. Vrachatis1Charalampos Kossyvakis2Sotiria G. Giotaki3Gerasimos Deftereos4Maria Kousta5Ioannis Anagnostopoulos6Dimitrios Avramides7George Giannopoulos8Vaia Lambadiari9Gerasimos Siasos10Spyridon Deftereos112nd Department of Cardiology, National and Kapodistrian University of Athens, 11527 Athens, Greece2nd Department of Cardiology, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, Greece2nd Department of Cardiology, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, GreeceDepartment of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, GreeceDepartment of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, GreeceDepartment of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, Greece3rd Department of Cardiology, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceSecond Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Attikon University Hospital, 12462 Athens, Greece3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, 11527 Athens, Greece2nd Department of Cardiology, National and Kapodistrian University of Athens, 11527 Athens, GreeceBackground: Atrial fibrillation (AF) is prevalent among obese patients, and cryoballoon ablation (CBA) is an effective strategy for the rhythm control of AF. The impact of body mass index (BMI) on the clinical outcomes of CBA for AF is not fully explored. Methods: 85 consecutive patients with paroxysmal AF were enrolled and were categorized into three groups as per their BMI: normal weight (BMI 18.5–25 kg/m<sup>2</sup>), overweight (BMI 25–30 kg/m<sup>2</sup>), and obese patients (BMI > 30 kg/m<sup>2</sup>). The primary study endpoint was a late (12 month) recurrence of AF. Early recurrence of AF, symptom improvement, and procedural outcomes were some key secondary outcomes. Results: 20 patients had normal weight, 35 were overweight, and 30 were obese. Obese patients featured a higher prevalence of diabetes mellitus, heavier exposure to smoking, and worse baseline symptoms (as assessed through EHRA class at admission and 12 months before CBA) compared to overweight and normal weight patients. Both late and early (<3 months) AF recurrence rates were comparable across the three groups. Of note, obese patients showed greater improvement in their symptoms post-CBA, defined as improvement by at least one EHRA class, compared to normal weight patients; this might be explained by improved diastolic function. Total procedure time and dose area product were significantly increased in obese patients. The multivariate logistic regression analysis indicated that early AF recurrence and the duration of hypertension are independent predictors of late AF recurrence. Conclusion: CBA is effective in overweight and obese patients with paroxysmal AF. Procedure time and radiation exposure are increased in obese patients undergoing CBA.https://www.mdpi.com/2039-7283/14/6/192atrial fibrillationobesitybody mass indexpulmonary vein isolationcryoablation |
| spellingShingle | Konstantinos A. Papathanasiou Dimitrios A. Vrachatis Charalampos Kossyvakis Sotiria G. Giotaki Gerasimos Deftereos Maria Kousta Ioannis Anagnostopoulos Dimitrios Avramides George Giannopoulos Vaia Lambadiari Gerasimos Siasos Spyridon Deftereos Impact of Body Mass Index on the Outcomes of Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation Clinics and Practice atrial fibrillation obesity body mass index pulmonary vein isolation cryoablation |
| title | Impact of Body Mass Index on the Outcomes of Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation |
| title_full | Impact of Body Mass Index on the Outcomes of Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation |
| title_fullStr | Impact of Body Mass Index on the Outcomes of Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation |
| title_full_unstemmed | Impact of Body Mass Index on the Outcomes of Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation |
| title_short | Impact of Body Mass Index on the Outcomes of Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation |
| title_sort | impact of body mass index on the outcomes of cryoballoon pulmonary vein isolation for paroxysmal atrial fibrillation |
| topic | atrial fibrillation obesity body mass index pulmonary vein isolation cryoablation |
| url | https://www.mdpi.com/2039-7283/14/6/192 |
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