Po-02-218 impact of obesity on catheter ablation of atrial fibrillation: patient characteristics, procedural complications, outcomes and quality of life

Background Obesity is a well-known risk factor for atrial fibrillation (AF). Objective To evaluate the effect of baseline obesity on procedural complications, AF recurrence, and symptoms following catheter ablation (CA). Methods A total of 5841 patients undergoing AF ablation (2013-2021) were enrolled in a prospectively maintained registry. Primary endpoint was AF recurrence based on electrocardiographic documentation. Patients were categorized into 5 groups according to their baseline body mass index (BMI). Patients survey at baseline and at follow-up were used to calculate AF severity score (AFSS) as well as AF burden. Results Major procedural complications were low (1.5%) among BMI sub-groups. At 3 years AF recurrence was highest in Class III obesity patients (48%) followed by Class II (43%), whereas Class I, normal, and overweight had similar results with lower recurrence (35%). In multivariable analyses, Class III obesity was independently associated with increased risk for AF recurrence (HR=1.30, P=0.01), whereas other groups had similar risk in comparison to normal weight. Baseline AFSS was lowest in normal weight, and highest in Obesity-III, median [interquartile range] 10 [5-16] vs 15 [10-21]. In all groups, CA resulted in improvement in their AFSS with a similar magnitude among the groups. At follow-up, AF burden was minimal and did not differ significantly between the groups. Conclusion AF ablation is safe with a low complication rate across all BMI groups. Morbid obesity (BMI ≥40) was significantly associated with reduced AF ablation success. However, ablation resulted in improvement in QOL including reduction of the AFSS, and AF burden. What is known? What is known? More obese patients are being referred to catheter ablation of AF. What is new? ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work has not been funded ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ourstudy was approved by the Cleveland Clinic Institutional Review Board. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data are available based on a reasonable request.