Impact of body mass index on cryoablation of atrial fibrillation: Patient characteristics, procedural data, and long‐term outcomes.

Introduction: Ablation of atrial fibrillation in the context of obesity can be challenging. We sought to evaluate the role of cryoballoon pulmonary vein isolation (CB‐PVI) in obese patients with symptomatic atrial fibrillation (AF). Methods: Patients with a BMI ≥ 25 kg/m2 and symptomatic AF who unde...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 33; no. 6; pp. 1106 - 1116
Autores principales: Urbanek, Lukas, Bordignon, Stefano, Chen, Shaojie, Bologna, Fabrizio, Tohoku, Shota, Dincher, Matthias, Schulte‐Hahn, Britta, Schmidt, Boris, Chun, Kyoung‐Ryul Julian
Formato: diagnostic images research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Jun2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2022
      vid: 33
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jce.15478
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        atl: Impact of body mass index on cryoablation of atrial fibrillation: Patient characteristics, procedural data, and long‐term outcomes.
      aug:
        au:
          Urbanek, Lukas
          Bordignon, Stefano
          Chen, Shaojie
          Bologna, Fabrizio
          Tohoku, Shota
          Dincher, Matthias
          Schulte‐Hahn, Britta
          Schmidt, Boris
          Chun, Kyoung‐Ryul Julian
        affil: Cardioangiologisches Centrum Bethanien, Agaplesion Markus‐Krankenhaus, Frankfurt am Main, Germany
      sug:
        subj:
          Atrial Fibrillation Surgery
          Cryosurgery Methods
          Cryosurgery Adverse Effects
          Obesity
          Body Mass Index
          Treatment Outcomes Evaluation
          Human
          Retrospective Design
          Record Review
          Surgical Patients Psychosocial Factors
          Comparative Studies
          Male
          Female
          Middle Age
          Aged
          Fluoroscopy
          Radiation Dosage
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Introduction: Ablation of atrial fibrillation in the context of obesity can be challenging. We sought to evaluate the role of cryoballoon pulmonary vein isolation (CB‐PVI) in obese patients with symptomatic atrial fibrillation (AF). Methods: Patients with a BMI ≥ 25 kg/m2 and symptomatic AF who underwent CB‐PVI were retrospectively enrolled. Three groups were defined (G1: BMI of 25–29 kg/m2; G2: BMI of 30–34 kg/m2; G3: BMI ≥ 35 kg/m2). Results: 600 patients were included (59% male; 66 ± 11 years old); 337, 149, and 114 were assigned to G1, G2, and G3, respectively. Acute procedural success was recorded in 99.7% of patients. Procedural and fluoroscopy time were comparable but the radiation dose was significantly higher in G3. Procedural complications were 3% in G1, 5.4% in G2, and 8.8% in G3 (p =.01). The overall freedom from AF after 1‐year was 77%. G3 had a significantly worse 1‐year success rate compared to G1 and G2 (G3: 66.5% vs. G1: 78.4%; p =.015 and vs. G2: 82.5%; p =.008) with reduced 1‐year success in paroxysmal AF (G1: 84.0%; G2: 86.3%; and G3: 69.6%) but not in persistent AF (G1: 68.7%; G2: 77.4%; and G3: 62.1%). G3 showed similar success rates irrespective of AF form (PAF: 69.6% vs. persAF 62.1%; p =.501). Conclusion: Cryoballoon ablation in obese patients can be effective with an acceptable safety profile, 77% of patients were in stable SR at 1 year. Severe obese patients (BMI ≥ 35) showed reduced procedural safety and 1‐year success rate. In association with life style modification, CB ablation may represent a strategy to enhance rhythm control in the context of obesity.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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