High ABSI values and association with AF recurrence after AF ablation: a prospective single-center study

Studies have shown that obesity is an independent risk factor for the development of atrial fibrillation (AF). Body Mass Index (BMI) and waist circumference (WC) have become accepted indicators of obesity. However, BMI is not sufficient to locate the fat-muscle distribution pattern and the fat-muscle ratio of the body. A Body Shape Index (ABSI) based on WC adjusted for height and weight: ABSI: WC/(BMI2/3 x height½ ). High ABSI is associated with higher all-cause, cardiovascular, and cancer mortality than BMI, WC, waist-to-height ratio. Our aim was to investigate ABSI score characteristics in patients undergoing RF (radiofrequency) ablation of AF.

A total of 345 consecutive patients who underwent catheter ablation for atrial fibrillation between October 2015 and April 2019 were included in this study. Patients were followed up one month after the procedure and then every 3 months for one year. Recurrent AF was defined as an AF episode lasting longer than 30 seconds on Holter recording or ECG recording.

ABSI value was higher in the AF recurrence group than in the patients without recurrence (0.0908±.0119 vs. 0.084±0.009, p=0.00*). We divided the study population into quintiles according to the ABSI z-score, with the middle (third) quintile comprising those who were near the population mean ABSI. The highest percentage of patients was observed in quintile 5.  Patients with AF recurrence had a higher proportion of patients in quintile 5 than patients without recurrence. 65.1% of patients with AF recurrence were in quintile 5, while only 37.6% of patients without recurrence were in quintile 5 (p=0.003).

High ABSI values indicate patients at high risk for AF. These patients should be better monitored for AF-related complications. Electrophysiologists should keep in mind that patients with high ABSI are at increased AF risk of recurrence.