0 63

Cited 0 times in

Impact of abdominal obesity on outcomes of catheter ablation in Korean patients with atrial fibrillation

Authors
 Wern Yew Ding  ;  Pil-Sung Yang  ;  Eunsun Jang  ;  Dhiraj Gupta  ;  Jung-Hoon Sung  ;  Boyoung Joung  ;  Gregory Y H Lip 
Citation
 INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Vol.75(10) : e14696, 2021-10 
Journal Title
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
ISSN
 1368-5031 
Issue Date
2021-10
MeSH
Atrial Fibrillation* / epidemiology ; Atrial Fibrillation* / surgery ; Brain Ischemia* ; Catheter Ablation* ; Female ; Humans ; Male ; Middle Aged ; Obesity / complications ; Obesity / epidemiology ; Obesity, Abdominal* / complications ; Obesity, Abdominal* / epidemiology ; Recurrence ; Republic of Korea / epidemiology ; Risk Factors ; Stroke* ; Treatment Outcome
Abstract
Background: Effects of abdominal obesity on outcomes of atrial fibrillation (AF) ablation remains ill-defined. Here, we evaluated the impact of abdominal obesity on the long-term efficacy and safety of catheter AF ablation among Korean patients.
Methods: We utilised the Korean National Health Insurance Service database to identify patients who underwent AF ablation. Abdominal obesity was defined as waist circumference ≥90 cm (males) and ≥85 cm (females). The primary endpoint was AF recurrence and secondary endpoints were ischaemic stroke, intracranial haemorrhage and death. Additionally, safety endpoints of peri-procedural complications were studied.

Results: Among 5397 patients (median age 58 [IQR 51-65] years; 23.6% females), abdominal obesity was present in 1759 (32.6%). The rate of AF recurrence was not statistically different between the groups at 1-year (10.3 vs 8.7 events/100-PYs, P = .078), though abdominal obesity was associated with significantly higher rates of AF recurrence at 3-year (7.6 vs 6.3 events/100-PYs, P = .008) and 6-year (6.3 vs 5.2 events/100-PYs, P = .004) follow-ups. Kaplan-Meier survival analysis found significantly higher rates of AF recurrence in patients with obesity based on body mass index (BMI) and waist circumference (log-rank for trend P = .006). Using multivariable regression analysis, obesity by both BMI and waist circumference was an independent predictor for AF recurrence (HR 1.21 [95% CI, 1.05-1.40]), after accounting for other risk factors. There was a trend for increased rates of ischaemic stroke at 3-year and 6-year follow-ups in patients with abdominal obesity. Furthermore, this group of patients had a greater rate of intracranial haemorrhage. All-cause death was comparable between both groups. Total peri-procedural complications were not associated with abdominal obesity.
Conclusion: Abdominal obesity as indicated by waist circumference was associated with a greater burden of concomitant diseases and an independent risk factor for long-term redo AF intervention following catheter ablation but had no effects on total peri-procedural complications.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/ijcp.14696
DOI
10.1111/ijcp.14696
Appears in Collections:
1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Jang, Eunsun(장은선) ORCID logo https://orcid.org/0000-0001-6991-4765
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/186871
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links