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Tytuł:
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Impact of abdominal obesity on outcomes of catheter ablation in Korean patients with atrial fibrillation.
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Autorzy:
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Ding WY; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
Yang PS; Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Jang E; Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Gupta D; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
Sung JH; Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Joung B; Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Lip GYH; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Źródło:
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International journal of clinical practice [Int J Clin Pract] 2021 Oct; Vol. 75 (10), pp. e14696. Date of Electronic Publication: 2021 Aug 06.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2022- : Mumbai : Hindawi
Original Publication: Esher [England] ; Bronxville, N.Y. : Medicom International, c1997-
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MeSH Terms:
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Atrial Fibrillation*/epidemiology
Atrial Fibrillation*/surgery
Brain Ischemia*
Catheter Ablation*
Obesity, Abdominal*/complications
Obesity, Abdominal*/epidemiology
Stroke*
Female ; Humans ; Male ; Middle Aged ; Obesity/complications ; Obesity/epidemiology ; Recurrence ; Republic of Korea/epidemiology ; Risk Factors ; Treatment Outcome
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References:
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Di Cesare M, Bentham J, Stevens GA, et al. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet. 2016;387:1377-1396.
Wang TJ, Parise H, Levy D, et al. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004;292:2471-2477.
Carlsson AC, Riserus U, Arnlov J, et al. Prediction of cardiovascular disease by abdominal obesity measures is dependent on body weight and sex-results from two community based cohort studies. Nutr Metab Cardiovasc Dis. 2014;24:891-899.
Frost L, Benjamin EJ, Fenger-Gron M, et al. Body fat, body fat distribution, lean body mass and atrial fibrillation and flutter. A Danish cohort study. Obesity. 2014;22(6):1546-1552.
Aune D, Sen A, Schlesinger S, et al. Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose-response meta-analysis of prospective studies. Eur J Epidemiol. 2017;32:181-192.
Kim D, Yang P-S, Jang E, et al. Increasing trends in hospital care burden of atrial fibrillation in Korea, 2006 through 2015. Heart. 2018;104:2010-2017.
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Shang L, Shao M, Guo Q, et al. Association of obesity measures with atrial fibrillation recurrence after cryoablation in patients with paroxysmal atrial fibrillation. Med Sci Monit. 2020;26:e920429.
Letsas KP, Siklody CH, Korantzopoulos P, et al. The impact of body mass index on the efficacy and safety of catheter ablation of atrial fibrillation. Int J Cardiol. 2013;164:94-98.
Lakkireddy DR, Blake GE, Patel D, et al. Success of radiofrequency catheter ablation of atrial fibrillation: does obesity influence the outcomes? J Atr Fibrillation. 2008;1:36.
Winkle RA, Mead RH, Engel G, et al. Impact of obesity on atrial fibrillation ablation: patient characteristics, long-term outcomes, and complications. Heart Rhythm. 2017;14:819-827.
Wong CX, Sullivan T, Sun MT, et al. Obesity and the risk of incident, post-operative, and post-ablation atrial fibrillation: a meta-analysis of 626,603 individuals in 51 studies. JACC Clin Electrophysiol. 2015;1:139-152.
Guijian L, Jinchuan Y, Rongzeng D, et al. Impact of body mass index on atrial fibrillation recurrence: a meta-analysis of observational studies. Pacing Clin Electrophysiol. 2013;36:748-756.
Romero-Corral A, Somers VK, Sierra-Johnson J, et al. Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes. 2008;32:959-966.
Chan JCN, Malik V, Jia W, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301:2129-2140.
Hamada R, Lee JS, Mori K, Watanabe E, Muto S. Influence of abdominal obesity and habitual behaviors on incident atrial fibrillation in Japanese. J Cardiol. 2018;71:118-124.
Baek Y-S, Yang P-S, Kim T-H, et al. Associations of abdominal obesity and new-onset atrial fibrillation in the general population. J Am Heart Assoc. 2017;6.
Glover BM, Hong KL, Dagres N, et al. Impact of body mass index on the outcome of catheter ablation of atrial fibrillation. Heart. 2019;105:244-250.
Friedman DJ, Pokorney SD, Ghanem A, et al. Predictors of cardiac perforation with catheter ablation of atrial fibrillation. JACC Clin Electrophysiol. 2020;6:1098.
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Grant Information:
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Korean Health Industry Development Institute; HI15C1200 Ministry of Health & Welfare; HC19C0130 Ministry of Health & Welfare; United Kingdom MRC_ Medical Research Council
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Entry Date(s):
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Date Created: 20210802 Date Completed: 20210921 Latest Revision: 20210921
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Update Code:
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20240105
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DOI:
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10.1111/ijcp.14696
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PMID:
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34338415
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Background: Effects of abdominal obesity on outcomes of atrial fibrillation (AF) ablation remains ill-defined. Here, we evaluated the impact of abdominal obesity on the long-term efficacy and safety of catheter AF ablation among Korean patients.
Methods: We utilised the Korean National Health Insurance Service database to identify patients who underwent AF ablation. Abdominal obesity was defined as waist circumference ≥90 cm (males) and ≥85 cm (females). The primary endpoint was AF recurrence and secondary endpoints were ischaemic stroke, intracranial haemorrhage and death. Additionally, safety endpoints of peri-procedural complications were studied.
Results: Among 5397 patients (median age 58 [IQR 51-65] years; 23.6% females), abdominal obesity was present in 1759 (32.6%). The rate of AF recurrence was not statistically different between the groups at 1-year (10.3 vs 8.7 events/100-PYs, P = .078), though abdominal obesity was associated with significantly higher rates of AF recurrence at 3-year (7.6 vs 6.3 events/100-PYs, P = .008) and 6-year (6.3 vs 5.2 events/100-PYs, P = .004) follow-ups. Kaplan-Meier survival analysis found significantly higher rates of AF recurrence in patients with obesity based on body mass index (BMI) and waist circumference (log-rank for trend P = .006). Using multivariable regression analysis, obesity by both BMI and waist circumference was an independent predictor for AF recurrence (HR 1.21 [95% CI, 1.05-1.40]), after accounting for other risk factors. There was a trend for increased rates of ischaemic stroke at 3-year and 6-year follow-ups in patients with abdominal obesity. Furthermore, this group of patients had a greater rate of intracranial haemorrhage. All-cause death was comparable between both groups. Total peri-procedural complications were not associated with abdominal obesity.
Conclusion: Abdominal obesity as indicated by waist circumference was associated with a greater burden of concomitant diseases and an independent risk factor for long-term redo AF intervention following catheter ablation but had no effects on total peri-procedural complications.
(© 2021 The Authors. International Journal of Clinical Practice published by John Wiley & Sons Ltd.)