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Atrial Fibrillation Ablation in Obese Patients
Matthew Needleman1, Hugh Calkins
1Section of Cardiac Electrophysiology, Division of Cardiology, Johns Hopkins Medical Institutes, Sheikh Zayed Tower - Room 7125, 1800 Orleans Street, Baltimore, MD 21287, USA.
Cardiac Electrophysiology Clinics
|March 5, 2016
Summary
Obese patients with atrial fibrillation (AF) may experience similar mortality rates due to the "obesity paradox." Catheter ablation is viable but requires careful screening and counseling for obese individuals.
Area of Science:
- Cardiology
- Obesity Medicine
Background:
- Atrial fibrillation (AF) poses a significant health burden.
- The
- obesity paradox
- describes similar or improved mortality in obese patients with AF.
Purpose of the Study:
- To evaluate the efficacy and safety of catheter ablation for AF in obese patients.
- To identify specific considerations for obese individuals undergoing AF ablation.
Main Methods:
- Review of outcomes for obese patients undergoing catheter ablation for AF.
- Analysis of procedural characteristics, complications, and success rates in obese versus non-obese cohorts.
Main Results:
- Catheter ablation is a reasonable option for obese patients with AF.
- Obese patients may require longer procedures and repeat ablations for similar success rates.
- No statistically significant increase in procedural complications observed, but counseling on radiation dose and left atrial thrombus is recommended.
Conclusions:
- Successful AF ablation can improve quality of life in obese patients.
- Screening for sleep apnea is crucial in obese patients undergoing AF ablation.
- Informed consent should include potential for longer procedures, repeat procedures, increased radiation, and preablation left atrial thrombus risk.
