Cryoablation for pulmonary veins isolation in obese patients with atrial fibrillation compared to nonobese patients.
Background: Pulmonary veins isolation (PVI) by cryoballoon (CB) ablation is marginally represented in clinical studies in obese patients. The aim of this analysis was to evaluate the safety and efficacy of CB‐PVI in a large cohort of overweight and obese patients from the 1STOP project. Methods: Fro...
| Published in: | Pacing & Clinical Electrophysiology Vol. 44; no. 2; pp. 306 - 318 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Feb2021
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148723238&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148723238 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Feb2021 vid: 44 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 148723238 148055496 148723238 148723238 10.1111/pace.14149 148723238 ppf: 306 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Cryoablation for pulmonary veins isolation in obese patients with atrial fibrillation compared to nonobese patients. aug: au: Malaspina, Daniele Brasca, Francesco Iacopino, Saverio Arena, Giuseppe Molon, Giulio Pieragnoli, Paolo Tondo, Claudio Manfrin, Massimiliano Rovaris, Giovanni Verlato, Roberto Dello Russo, Antonio Startari, Umberto Sgarito, Giuseppe Perego, Giovanni Battista affil: Department of Cardiology, ASST Santi Paolo e Carlo, Presidio Ospedaliero San Carlo Borromeo, Milano, Italy sug: subj: Cryosurgery Methods Atrial Fibrillation Pulmonary Veins Surgery Obesity Patient Safety Evaluation Outcome Assessment Human Male Female Middle Age Aged Comparative Studies Descriptive Statistics Body Mass Index Risk Assessment After Care Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Pulmonary veins isolation (PVI) by cryoballoon (CB) ablation is marginally represented in clinical studies in obese patients. The aim of this analysis was to evaluate the safety and efficacy of CB‐PVI in a large cohort of overweight and obese patients from the 1STOP project. Methods: From 2012 to 2018, 2048 patients with atrial fibrillation (AF) (70% male, 59 ± 11 years; 75% paroxysmal AF) underwent index CB‐PVI. The patient data were separated into three cohorts for statistical evaluation, including: normal weight (body mass index [BMI] < 25 kg/m2), overweight (BMI = 25‐30 kg/m2), and obese patients (BMI > 30 kg/m2). Results: Out of 2048 patients, 693 (34%) patients had a BMI < 25 and were deemed as normal. There were 944 (46%) patients categorized as overweight (BMI = 25‐30) and 411 (20%) as obese (BMI > 30). Overweight or obese patients were more often in persistent AF, had more frequently hypertension and diabetes, had higher CHA2DS2‐VASc score, and had a number of failed antiarrhythmic drug (AAD). Periprocedural complication rates were similar among the three cohorts. The 12‐month freedom from AF recurrence was 76.4% in the normal BMI group as compared to 79.2% in the overweight and 73.5% in the obese group (p =.35). However, 48% of overweight patients were on AAD treatment during the follow‐up. By multivariate analysis, BMI was not a predictor for AF recurrence following the index CB‐PVI. Conclusion: CB‐PVI in obese patients is a safe procedure. Increased BMI (either moderate or severe) does not seem to be associated with a worse outcome or to a different rate of AAD discontinuation at 12 months. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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