As quite a lot of data has been recently reported on the impact of body mass index (BMI) on the risk of atrial fibrillation (AF) development, peri-procedural risk in pulmonary vein isolation (PVI) and PVI outcome, as well as quality of life (QoL) after PVI, we would like to dedicate our review to these topics.
BMI has been shown to be associated with short and long term elevations in AF risk which may give a reason of the rapidly increasing prevalence of AF over the last decades. A strategy of weight control will be crucial to reduce the increasing incidence of AF in the future.
BMI is an independent predictor of a LA/LAA thrombus in patients with AF rendering anticoagulation treatment and pre-procedural TEE fundamental in obese patients. Higher BMI is not associated with an increased rate of major peri-procedural complications.
Conflicting data exists about the impact of BMI on recurrent AF after catheter ablation therapy.
QoL improvement still is the number one indication for AF ablation and can be accomplished by catheter ablation of AF. Obese patients seem to benefit even more from PVI compared to normal BMI patients considering different QoL scores.
Credits: Martin Martinek, MD; Helmut Purerfellner, MD, FHRS, FESC