Scientists from Gentofte University Hospital found overweight patients with atrial fibrillation are more likely to experience a return of the heart rhythm disorder after a corrective procedure than those of normal weight.
They suggest that overweight patients should be advised to lose weight before the intervention to improve the likelihood of being free of arrhythmia afterwards.
The research was presented at EHRA 2022 and was conducted by Dr. Jacob Toennesen et al.
Atrial fibrillation is the most common heart rhythm disorder worldwide. It is estimated that one in three Europeans will develop the condition.
Atrial fibrillation is associated with elevated risks of stroke, heart failure and premature death, while more than 60% of patients have impaired quality of life.
Treatment options include drugs and ablation, which involves burning or freezing a small portion of the heart to create a scar and prevent the spread of abnormal electrical impulses.
While previous research has shown that obesity is associated with the development of atrial fibrillation, this study examined the link between BMI and a return of heart rhythm disorder after ablation.
The team examined a total of 9,229 adults who underwent a first-time atrial fibrillation from 2010 through 2018.
The authors analyzed the relative risk of recurrent atrial fibrillation according to BMI.
At one year, compared to the normal weight group, the overweight, obese and morbidly obese groups had a 19%, 22% and 32% higher likelihood of atrial fibrillation, respectively.
The same pattern was observed after five years, with 15%, 18% and 26% higher risks of the abnormal heart rhythm in the overweight, obese and morbidly obese groups, respectively, compared with the normal weight group.
The relative risk in underweight patients did not strongly differ from those with normal weight at either time point.
The study shows that recurrence rates of atrial fibrillation increased incrementally with rising BMI at short- and long-term follow-up.
For instance, after one year 61% of normal weight patients were still free of the heart rhythm disorder compared to just 52% of morbidly obese patients.
The strength of association between high BMI and repeat atrial fibrillation after ablation was comparable to the influence of well-known factors like heart failure, COPD and hypertension which are typically treated in these patients.
The findings indicate that aggressive weight management prior to ablation could potentially lead to better outcomes.
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