Wpływ otyłości na skuteczność kardiowersji elektrycznej u pacjentów z przetrwałym migotaniem przedsionków

Abstract

Introduction: Obesity's influence on the effectiveness of electrical cardioversion (CVE) still requires more studies. The study aimed to evaluate the impact of obesity on the efficacy of CVE in atrial fibrillation (AF).Material and methods: Eighty-nine patients [female/male (F/M): 33/56; mean age: 64.66 ± 9.7 years) with persistent symptomatic AF qualified for CVE were prospectively enrolled in the study. CVE efficacy was analyzed immediately after the procedure and in a one-month follow-up. Patients with immediately efficient CVE were divided into obese group [OG; body mass index) BMI ≥ 30 kg/m 2 , 49 patients, F/M: 21/28, mean age: 64 ± 10 y.) and non-obese group (NOG; < 30 kg/m 2 , 33 patients, F/M: 9/24, mean age: 66 ± 10 y.).Results: Immediate CVE efficacy was 92%. Sinus rhythm restoration was not BMIdependent, but BMI had an impact on the amount of energy needed for sinus rhythm restoration (150 J in NOG vs. 200 J in OG, p < 0.05). One-month CVE efficacy was 47%: 38.8% in OG and 60.6% in NOG (p < 0.05). Patients in OG had greater left atrium (LA) and left ventricle (LV) diameters (p < 0.05) and lower LV ejection fraction (EF) (p < 0.05) as compared to NOG subjects. Logistic regression analysis revealed LV EF [odds ratio (OR):1.107, 95% CI: 1.015-1.207, p < 0.05] as a factor influencing one-month CVE efficacy. Conclusions:Immediate high efficacy of CVE in persistent AF seems to be independent of coexisting obesity, however, obesity has an impact on the amount of energy needed for sinus rhythm restoration. One-month efficacy of CVE is low and modified by coexisting obesity.