Impact of body mass index on atrial fibrillation recurrence: a meta-analysis of observational studies.

BACKGROUND: Obesity is associated with increased risk of atrial fibrillation (AF). Several trials exploring the impact of elevated body mass index (BMI) on the catheter ablation of AF have been published and yield conflicting results. We thus conducted a meta-analysis to explore the association between elevated BMI and AF recurrence in patients undergoing catheter ablation.
METHODS: A systematic review and meta-analysis was performed. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled.
RESULTS: Six observational studies including 2,358 patients were included. Of those, four studies were prospective cohort studies, and two were retrospective studies. Elevated BMI increased the risk of AF recurrence compared to normal BMI by 31%, where the difference between the two arms was statistically significant (RR = 1.308, 95% CI: 1.036-1.651, P = 0.02). Compared to normal BMI group, the overweight group had a 27% increased risk of AF recurrence (RR = 1.270, 95% CI 0: 961-1.679, P = 0.093) and the obese group had a significantly increased risk of AF recurrence (RR = 1.378, 95% CI: 1.006-1.887, P = 0.045). When compared to the overweight group, the obese group has a 12% increased risk of AF recurrence (RR = 1.116, 95% CI: 0.866-1.438, P = 0.397).
CONCLUSIONS: Elevated BMI is associated significantly with AF recurrence in patients undergoing catheter ablation. There is a graded relationship between elevated BMI and increased risk of AF recurrence. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.