| Sumario: | Introduction: Morbid obesity is a well‐known risk factor for the development of Atrial Fibrillation (AF); however, its influence in patients undergoing Catheter Ablation (CA) for AF is poorly recognized. Methods: The NRD (2016–2020) was used to identify CA for AF. Cohorts were stratified as non‐obese (BMI <25), obese (BMI 30–39), and morbidly obese (BMI ≥ 40). Multivariate regression and propensity‐matched models were used. Results: Among 83,767 CAs for AF, 10,590 (12.6%) were morbidly obese population. On propensity‐matched cohorts (N: 5741), morbid obesity was associated with higher rates of acute HF (39.1% vs. 34.5%), sudden cardiac arrest (5.6% vs. 4.7%), post‐procedural bleeding (1.95% vs. 1.36%), AKI (21.7% vs. 16.3%), and respiratory complications (18.9% vs. 13.2%). Morbid obesity was also associated with higher median LOS (4 vs. 3 days) and higher total cost ($43,768 vs. $39,026). From 2016–2020, the total cost increased irrespective of the obesity status (ptrend < 0.05); however, LOS showed a decreasing trend for non‐obese (ptrend < 0.05) but remained the same for morbidly obese patients (ptrend > 0.05). The 30‐day (11.7% vs. 8.4%) and 180‐day (29.9% vs. 24.9%) all‐cause readmission rates were significantly higher for the morbidly obese compared to non‐obese patients. Post‐discharge, AF was the most common cause (69.2% & 66.8%) for 30 and 180‐day readmissions. Our subgroup analysis comparing obese (BMI 30–39) to non‐obese showed higher rates of periprocedural acute HF and respiratory complications (p < 0.05). Conclusion: Morbid obesity in patients undergoing CA for AF was associated with higher rates of periprocedural adverse events, healthcare‐related burden, and readmission rates.
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