Obesity, a state of chronic low-grade inflammation, has reached epidemic proportions, and is associated with increased all-cause mortality. Atrial fibrillation (AF), the most common sustained arrhythmia in the clinical practice, is associated with an increased long-term risk of stroke, heart failure, and all-cause mortality. Accumulating data points out to an indispensable role of inflammation in the genesis and maintenance of AF. Recent studies have documented an increasing risk of AF with increasing body mass index (BMI). The pathophysiological alterations associated with overweight and obesity lead to atrial stretch and atrial enlargement creating the substrate for AF development. Catheter ablation of AF has been widely accepted as an important therapeutic modality for the treatment of patients with symptomatic, drug-refractory AF. Previous studies assessing the impact of BMI on AF catheter ablation outcomes have given conflicting data. Given that overweigh and obesity, as defined by BMI, and AF are closely linked, the present review sought to investigate the impact of BMI on the efficacy and safety of AF catheter ablation.
Credits: Louiza Lioni, MD; Panagiotis Korantzopoulos, MD; Konstantinos P. Letsas, MD, FESC