Copenhagen, Denmark – 4 April 2022: 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, according to research presented at EHRA 2022, a scientific congress of the European Society of Cardiology (ESC).1
“The risk of recurrent atrial fibrillation after ablation rose incrementally as body mass index (BMI) increased,” said lead author Dr. Jacob Toennesen of Gentofte University Hospital, Denmark. “Our study suggests that overweight patients should be advised to lose weight before the intervention to improve the likelihood of being free of the arrhythmia afterwards.”
Atrial fibrillation is the most common heart rhythm disorder worldwide.2 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.2 Dr. Toennesen said: “The potential for deleterious outcomes means that obtaining a normal heart rhythm is a crucial goal of treatment.”
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 the heart rhythm disorder after ablation.
The study was conducted using Danish nationwide registries. It included a total of 9,229 adults who underwent a first-time atrial fibrillation from 2010 through 2018. Patients were divided into five groups according to BMI in kg/m2: underweight (below 18.5), normal weight (18.5 to 24), overweight (25 to 29), obese (30 to 34) and morbidly obese (over 34). The median age decreased from 64 years in the normal weight group to 60 years in the morbidly obese group.
Patients were deemed to have experienced atrial fibrillation during follow-up if they claimed prescriptions of anti-arrhythmic drugs, were hospitalised due to atrial fibrillation, underwent re-ablation, or had an electrical cardioversion which transmits electric shocks to the heart through electrodes on the chest to restore normal heart rhythm.
The authors analysed the relative risk of recurrent atrial fibrillation according to BMI after adjusting for sex, age, procedure year, heart failure, ischaemic heart disease, chronic obstructive pulmonary disease (COPD), chronic kidney disease, hypertension and diabetes. 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 significantly differ from those with normal weight at either time point.
Dr. Toennesen said: “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. We also observed that both procedure duration and X-ray dose increased with rising BMI.”
He concluded: “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.”
Authors: ESC Press Office
Mobile: +33 (0)7 8531 2036
Follow us on Twitter @ESCardioNews
Notes to editor
Funding: The study was supported by Novo Nordisk.
References and notes
1The abstract “Recurrence rates of atrial fibrillation ablation according to body mass Index, a nationwide, registry-based Danish study” will be presented during the session “Atrial fibrillation: new insights” which takes place on 4 April at 11:05 CEST in Room 2.
2Hindricks G, Potpara T, Nikolaos Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021;42:373–498.
The European Heart Rhythm Association (EHRA) is a branch of the European Society of Cardiology (ESC). Its aim is to improve patients’ quality of life and reduce sudden cardiac death by limiting the impact of heart rhythm disturbances.
About the EHRA Congress #EHRA2022
EHRA 2022 is the annual congress of the European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC).
The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.
Information for journalists about registration for EHRA 2022
EHRA 2022 takes 3 to 5 April at the Bella Center in Copenhagen, Denmark and online. Explore the scientific programme.
- Free registration applies to accredited press.
- Credentials: A valid press card or appropriate letter of assignment with proof of three recent published articles. Read the ESC media and embargo policy.
- The ESC Press Office will verify the documents and confirm by email that your press accreditation is valid.
- The ESC Press Office decision is final regarding all press registration requests.