Association of Obesity Measures with Atrial Fibrillation Recurrence After Cryoablation in Patients with Paroxysmal Atrial Fibrillation

Shang, Luxiang; Shao, Mengjiao; Guo, Qilong; Xiaokereti, Jiasuoer; Zhao, Yang; Lu, Yanmei; Zhang, Ling; Zhou, Xianhui

doi:10.12659/msm.920429

Cited by 4 publications

(4 citation statements)

References 44 publications

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“…18 These results suggest that waist circumference may be superior to BMI for the prediction of incident AF. Moreover, the study by Shang et al 9 reported that of seven obesity indices, waist circumference was the only independent predictor of AF recurrence following ablation. Our study adds to this as it demonstrates that among patients with obesity by BMI, the additional presence of abdominal obesity was associated with a significantly elevated risk of AF recurrence following ablation.…”

Section: Comparison Of Abdominal Obesity and Bmimentioning

confidence: 99%

Impact of abdominal obesity on outcomes of catheter ablation in Korean patients with atrial fibrillation

et al. 2021

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Section: Comparison Of Abdominal Obesity and Bmimentioning

confidence: 99%

Impact of abdominal obesity on outcomes of catheter ablation in Korean patients with atrial fibrillation

et al. 2021

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“…[12][13][14] After a 90-day blanking period, AF recurrence rates within 1 year after the CBCA procedure have been reported to be as high as 31% to 40%. 15,16 Because CBCA is a high-cost procedure associated with a considerable recurrence rate, it would be desirable to estimate outcomes before recommending the patients to receive the CBCA procedure. Developing detailed patient selection criteria can enhance the overall efficacy and long-term success of the CBCA procedure.…”

Section: Introductionmentioning

confidence: 99%

Novel scoring system derived from meta‐analysis and validated in cohort population for predicting 1‐year atrial fibrillation recurrence after cryoballoon catheter ablation: The HeLPS‐Cryo score

Waranugraha,

Hsu,

Lin

et al. 2024

Pacing Clinical Electrophis

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BackgroundAtrial fibrillation (AF) recurrence rates in 1 year after cryoballoon ablation catheter (CBCA) are still high. We purposed to identify strong predictors for AF recurrence after the successful CBCA procedure and develop a new scoring system based only on pre‐procedural parameters.MethodsIn the derivation phase, a systematic review and meta‐analysis identified the strong predictors of AF recurrence after the CBCA. The pooled hazard ratio (HR) was used to create the new scoring system. The second phase validated the new scoring system in the cohort population.ResultsA meta‐analysis including 29 cohort studies with 16196 participants confirmed that persistent AF, stroke, heart failure, and left atrial diameter (LAD) >40 mm were powerful predictors for AF recurrence after the CBCA procedure. The HeLPS‐Cryo (heart failure [1], left atrial dilatation [1], persistent AF [2], and stroke [2]) was developed based on those pre‐procedural predictors. It was validated in 140 patients receiving CBCA procedures and revealed excellent predictive performance for 1‐year AF recurrence (AUC = 0.8877; 95% CI = 0.8208 to 0.9546). The HeLPS‐Cryo score of ≥3 could predict 1‐year AF recurrence with sensitivity and specificity of 78.9% and 87.9%, respectively. The positive predictive value was 66.7%, and the negative predictive value was 93.1%.ConclusionThe HeLPS‐Cryo score can help the physician estimate the probability of 1‐year AF recurrence after the successful CBCA procedure. Patients with HeLPS‐Cryo score <3 are good candidates for the CBCA procedure.

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“…Sisti et al found that aging, a larger left atrium (LA) size, ventricular pacing, and the lack of AAD therapy independently increased the risk of AF progression to permanent AF 3 . Shang et al reported that a longer AF duration, an older age, a history of hypertension or thromboembolic events, and obesity were associated with an increased risk of AF recurrence after cryoablation 5 . De Vos et al investigated the atrial structural remodeling factors represented by the HATCH score.…”

Section: Introductionmentioning

confidence: 99%

“…3 Shang et al reported that a longer AF duration, an older age, a history of hypertension or thromboembolic events, and obesity were associated with an increased risk of AF recurrence after cryoablation. 5 De Vos et al investigated the atrial structural remodeling factors represented by the HATCH score. Nearly 50% of the patients with a HATCH score of more than 5 progressed to PersAF.…”

Section: Introductionmentioning

confidence: 99%

Factors predicting the progression from paroxysmal to persistent atrial fibrillation despite an index catheter ablation

Li,

Elimam,

et al. 2023

Cardiovasc electrophysiol

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IntroductionDespite undergoing an index ablation, some patients progress from paroxysmal atrial fibrillation (PAF) to persistent AF (PersAF), and the mechanism behind this is unclear. The aim of this study was to investigate the predictors of progression to PersAF after catheter ablation in patients with PAF.MethodsThis study included 400 PAF patients who underwent an index ablation between 2015 and 2019. The patients were classified into three groups based on their outcomes: Group 1 (PAF to sinus rhythm, n = 226), Group 2 (PAF to PAF, n = 146), and Group 3 (PAF to PersAF, n = 28). Baseline and procedural characteristics were collected, and predictors for AF recurrence and progression were evaluated.ResultsThe mean age of the patients was 58.4 ± 11.1 years, with 272 males. After 3 years of follow‐up, 7% of the PAF cases recurred and progressed to PersAF despite undergoing an index catheter ablation. In the multivariable analysis, a larger left atrial (LA) diameter and the presence of non‐pulmonary vein (PV) triggers during the index procedure independently predicted recurrence. Moreover, a larger LA diameter, the presence of non‐PV triggers, and a history of thyroid disease independently predicted AF progression.ConclusionThe progression from PAF to PersAF after catheter ablation is associated with a larger LA diameter, history of thyroid disease, and the presence of non‐PV triggers. Meticulous preprocedural evaluation, patient selection, and comprehensive provocation tests during catheter ablation are recommended.

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Association of Obesity Measures with Atrial Fibrillation Recurrence After Cryoablation in Patients with Paroxysmal Atrial Fibrillation

Cited by 4 publications

References 44 publications

Impact of abdominal obesity on outcomes of catheter ablation in Korean patients with atrial fibrillation

Impact of abdominal obesity on outcomes of catheter ablation in Korean patients with atrial fibrillation

Novel scoring system derived from meta‐analysis and validated in cohort population for predicting 1‐year atrial fibrillation recurrence after cryoballoon catheter ablation: The HeLPS‐Cryo score

Factors predicting the progression from paroxysmal to persistent atrial fibrillation despite an index catheter ablation

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