Abstract 19717: Body Mass Index and Outcomes of Pulmonary Vein Isolation

Introduction: Efficacy of pulmonary vein isolation in patients with obesity is controversial. Recent data suggest better outcomes in patients who undergo weight management. Hypothesis: Pulmonary vein isolation is safe and effective in obese patients. Methods: We reviewed data of 958 consecutive patients who underwent PVI between Dec 2010 and July 2012. The procedure included isolation of all pulmonary veins and left atrial substrate as needed. Long-term success, defined as freedom from any atrial arrhythmia lasting more than 30 seconds after 3 months blanking period, was assessed in the various subcategories of patients’ body mass indexes (BMI) Results: Our study included 958 patients: mean age 61.2 ± 10.4, 256 (27%) females, median AF duration of 4 years (Q1-Q3: 2,8), 422 (44%) persistent AF, CHA2DS2VASC score 2 (Q1-Q3: 1,3), mean EF of 54.5% ± 9.4. mean left atrium diameter of 4.26 ± 0.9 cm. Mean BMI was 30.6 ± 6.9. On long-term follow of 490 days (Q1-Q3: 202, 809), 454 (47%) patients had recurrent atrial arrhythmia (41% in patients with paroxysmal AF and 55% in those with persistent AF). Incidence of recurrent atrial arrhythmia did not differ between different subcategories of BMI: 9 of 14 (64%) patients with BMI 35, and 35 of 68 (51%) patients with BMI u003e40 had recurrent arrhythmia (p=0.51) No excess complications were noted in obese patients. Conclusions: Pulmonary vein isolation is effective for management of atrial fibrillation with no excess complications, even in patients with morbid obesity. Our study suggests that patients should not be denied AF ablation based on their BMI.