AT occurring after CPVA plus LALA is often due to incomplete MI ablation, but may also occur at the LA roof, and ridge between the LA appendage and left PVs. Failure to achieve MI block increases the risk of developing AT. Resumption of MI conduction may also be a mechanism for AT recurrence. (PACE 2010; 460-468).
CORNIER, MARC-ANDRE, CHARLES W. TATE, GARY K. GRUNWALD, AND DANIEL H. BESSESEN. Relationship between waist circumference, body mass index, and medical care costs. Obes Res. 2002;10: 1167-1172. Objective: Excessive visceral adiposity as measured by anthropomorphic measures may be more closely associated with adverse health consequences than body weight or body mass index (BMI), the more commonly obtained clinical measures. Waist circumference (WC) provides information about regional adiposity and may correlate with health care costs better than body weight or BMI.
Research Methods and Procedures:A total of 424 men (37%) and women (63%) were identified as they were seen in outpatient medical clinics at Denver Health, an integrated health care system serving a largely indigent population. Height, weight, and WC were measured by one examiner. Information on outpatient, laboratory, pharmacy, inpatient, and total charges attributable to each subject for the preceding year were obtained from computerized databases. Data on health care charges were divided into quartiles based on WC and BMI. Results: Total annual health care charges were significantly greater in the highest WC quartile (WC Ͻ 83.3 cm: $6062 Ϯ $784; 83.3 to 93.5 cm: $5968 Ϯ $812; 93.7 to 103.5 cm: $6369 Ϯ $1015; Ͼ103.5 cm: $8699 Ϯ $1092; p ϭ 0.047). Those with a WC Ͼ103.5 cm generated 85% more inpatient charges than the group with a WC Ͻ83.3 cm. Although there was a positive trend, BMI was not found to significantly correlate with total health care charges in this population sample.Discussion: These results suggest that abdominal adiposity as assessed by WC is associated with increased total health care charges and may be a better predictor of health care charges than the more widely used BMI.
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