Morbid obesity is associated with increased procedural complications and worse in-hospital outcomes after percutaneous left atrial appendage occlusion device implantation

Obesity has adverse effects on cardiovascular hemodynamics and is an independent risk factor for the induction and perpetuation of atrial fibrillation (AF). 1 Lavie C.J. Pandey A. Lau D.H. Alpert M.A. Sanders P. Obesity and atrial fibrillation prevalence, pathogenesis, and prognosis: effects of weight loss and exercise. J Am Coll Cardiol. 2017; 70: 2022-2035 Crossref PubMed Scopus (247) Google Scholar Percutaneous left atrial appendage occlusion (LAAO) has shown promising results in reducing stroke risk in select patients with AF who cannot be managed with a conventional long-term oral anticoagulation strategy. 2 Reddy V.Y. Sievert H. Halperin J. et al. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA. 2014; 312: 1988-1998 Crossref PubMed Scopus (631) Google Scholar In the landmark PROTECT-AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) trial evaluating the efficacy and safety of percutaneous LAAO, patients receiving an LAAO device had a mean body mass index (BMI) of 31.6 kg/m2 2; however, no distinct assessment of outcomes was conducted on the basis of body weight. In this study, we sought to analyze the association of body weight with procedural complications and inpatient adverse events in patients undergoing LAAO implantation.