open access

Vol 79, No 5 (2021)
Original article
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Is the extent of left atrial fibrosis associated with body mass index in patients undergoing pulmonary vein isolation for atrial fibrillation?

Janko Szavits Nossan, Igor Šesto, Krešimir Štambuk, Tomislav Šipić, Robert Bernat, Ivan Gudelj, Luka Rotkvić, Marinko Žulj, Jure Mirat
DOI: 10.33963/KP.15910
·
Pubmed: 34125926
·
Kardiol Pol 2021;79(5):531-538.

open access

Vol 79, No 5 (2021)
Original article

Abstract

Background: Left atrial (LA) fibrosis is associated with a higher rate of recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI). Body mass index (BMI) is strongly associated with the prevalence of AF, but there is insufficient data about the association between BMI and LA fibrosis.
Aims: The aim of the study was to examine the association between LA fibrosis and BMI in patients with AF undergoing PVI.
Methods: In 114 patients an electro-anatomical voltage map was created using the CARTO 3 three-dimensional system before PVI. The total fibrosis area (voltage criteria ≤0.5 mV), percentage, and the number of fibrotic areas were calculated. A general linear model was used to determine the differences in BMI with confounders between groups of patients with differing extents of fibrosis and numbers of focuses.
Results: Advanced fibrosis was found in 53 (47%) patients, in up to 9 areas with a median of 2 and an interquartile range (IQR) of 0–3. The median total fibrotic area was 27.3 cm2 with an IQR of 0.1–30.3 cm2. Patients were stratified by percentage of fibrotic area: <5%, 5%–20%, 20%–35%, and above 35%; no significant difference in mean BMI was found between the groups (P = 0.57). When stratified by the number of fibrotic areas (0, 1, 2, and ≥3 fibrotic areas), no difference in BMI was noted between the groups (P = 0.67).
Conclusions: Fibrosis of the LA, as the strongest predictor of AF recurrence after PVI, does not correlate with BMI in patients with AF where PVI is indicated.

Abstract

Background: Left atrial (LA) fibrosis is associated with a higher rate of recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI). Body mass index (BMI) is strongly associated with the prevalence of AF, but there is insufficient data about the association between BMI and LA fibrosis.
Aims: The aim of the study was to examine the association between LA fibrosis and BMI in patients with AF undergoing PVI.
Methods: In 114 patients an electro-anatomical voltage map was created using the CARTO 3 three-dimensional system before PVI. The total fibrosis area (voltage criteria ≤0.5 mV), percentage, and the number of fibrotic areas were calculated. A general linear model was used to determine the differences in BMI with confounders between groups of patients with differing extents of fibrosis and numbers of focuses.
Results: Advanced fibrosis was found in 53 (47%) patients, in up to 9 areas with a median of 2 and an interquartile range (IQR) of 0–3. The median total fibrotic area was 27.3 cm2 with an IQR of 0.1–30.3 cm2. Patients were stratified by percentage of fibrotic area: <5%, 5%–20%, 20%–35%, and above 35%; no significant difference in mean BMI was found between the groups (P = 0.57). When stratified by the number of fibrotic areas (0, 1, 2, and ≥3 fibrotic areas), no difference in BMI was noted between the groups (P = 0.67).
Conclusions: Fibrosis of the LA, as the strongest predictor of AF recurrence after PVI, does not correlate with BMI in patients with AF where PVI is indicated.

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Keywords

atrial fibrillation, body mass index, fibrosis, pulmonary vein isolation, recurrence

About this article
Title

Is the extent of left atrial fibrosis associated with body mass index in patients undergoing pulmonary vein isolation for atrial fibrillation?

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 79, No 5 (2021)

Article type

Original article

Pages

531-538

DOI

10.33963/KP.15910

Pubmed

34125926

Bibliographic record

Kardiol Pol 2021;79(5):531-538.

Keywords

atrial fibrillation
body mass index
fibrosis
pulmonary vein isolation
recurrence

Authors

Janko Szavits Nossan
Igor Šesto
Krešimir Štambuk
Tomislav Šipić
Robert Bernat
Ivan Gudelj
Luka Rotkvić
Marinko Žulj
Jure Mirat

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