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Body mass index as a determinant of scar formation post-AF ablation: Insights from DECAAF II. | LitMetric

AI Article Synopsis

  • Obesity negatively affects atrial remodeling and outcomes in patients with atrial fibrillation, with this study focusing on how body mass index (BMI) influences scar formation after catheter ablation.
  • Analysis of 811 patients revealed that higher baseline left atrial volume and more comorbidities were present in obese individuals, with Class 3 obesity showing the lowest rates of ablation-induced scar formation.
  • The study concluded that obese patients have less effective scar formation and more residual fibrosis following ablation compared to those with normal weight, indicating a significant impact of BMI on treatment outcomes.

Article Abstract

Introduction: Obesity is implicated in adverse atrial remodeling and worse outcomes in patients with atrial fibrillation. The objective of this study is to assess the effect of body mass index (BMI) on ablation-induced scar formation on late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR).

Methods: We conducted an analysis of DECAAF II participants who underwent LGE-CMR scans to measure scar formation 3 months after catheter ablation. Ablation parameters and lesion delivery were not dependent on BMI. The effect of BMI on ablation success was explored.

Results: Our analyses included 811 patients. Comorbidities were more prevalent in obese patients. Baseline left atrial volume was higher in obese individuals, 118, 126, 135, 140, and 143 mm for normal weight, overweight, obese grade 1, 2, and 3, respectively (p < .001). BMI was associated with scar formation (R = -0.135, p < .001), with patients with Class 3 obesity having the lowest percentage of ablation-induced scar, 11.1%, 10.3%, 9.5%, 8.8%, 6.8% by ascending BMI group. There was an inverse correlation between BMI and the amount of fibrosis covered by ablation scar, 24%, 23%, 21%, and 18% by ascending BMI group (p = .001). For the fibrosis-guided ablation group, BMI was associated with residual fibrosis (R = 0.056, p = .005).

Conclusion: Obese patients have lower ablation scar formation, covered fibrosis, and more residual fibrosis postablation compared to nonobese patients, regardless of ablation parameters including impedance drop.

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Source
http://dx.doi.org/10.1111/jce.16448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650536PMC

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