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

Wern Yew Ding, Pil Sung Yang, Eunsun Jang, Dhiraj Gupta, Jung Hoon Sung, Boyoung Joung, Gregory Y.H. Lip

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1 Citation (Scopus)


Background: Effects of abdominal obesity on outcomes of atrial fibrillation (AF) ablation remains ill-defined. Here, we evaluated the impact of abdominal obesity on the long-term efficacy and safety of catheter AF ablation among Korean patients. Methods: We utilised the Korean National Health Insurance Service database to identify patients who underwent AF ablation. Abdominal obesity was defined as waist circumference ≥90 cm (males) and ≥85 cm (females). The primary endpoint was AF recurrence and secondary endpoints were ischaemic stroke, intracranial haemorrhage and death. Additionally, safety endpoints of peri-procedural complications were studied. Results: Among 5397 patients (median age 58 [IQR 51-65] years; 23.6% females), abdominal obesity was present in 1759 (32.6%). The rate of AF recurrence was not statistically different between the groups at 1-year (10.3 vs 8.7 events/100-PYs, P =.078), though abdominal obesity was associated with significantly higher rates of AF recurrence at 3-year (7.6 vs 6.3 events/100-PYs, P =.008) and 6-year (6.3 vs 5.2 events/100-PYs, P =.004) follow-ups. Kaplan-Meier survival analysis found significantly higher rates of AF recurrence in patients with obesity based on body mass index (BMI) and waist circumference (log-rank for trend P =.006). Using multivariable regression analysis, obesity by both BMI and waist circumference was an independent predictor for AF recurrence (HR 1.21 [95% CI, 1.05-1.40]), after accounting for other risk factors. There was a trend for increased rates of ischaemic stroke at 3-year and 6-year follow-ups in patients with abdominal obesity. Furthermore, this group of patients had a greater rate of intracranial haemorrhage. All-cause death was comparable between both groups. Total peri-procedural complications were not associated with abdominal obesity. Conclusion: Abdominal obesity as indicated by waist circumference was associated with a greater burden of concomitant diseases and an independent risk factor for long-term redo AF intervention following catheter ablation but had no effects on total peri-procedural complications.

Original languageEnglish
Article numbere14696
JournalInternational Journal of Clinical Practice
Issue number10
Publication statusPublished - 2021 Oct

Bibliographical note

Funding Information:
This study was supported by a research grant from the Korean Healthcare Technology R&D project funded by the Ministry of Health & Welfare (HI15C1200, HC19C0130). We acknowledge funding for this collaboration from the Medical Research Council (MRC) and the Korean Health Industry Development Institute (KHIDI) Partnering Award.

Publisher Copyright:
© 2021 The Authors. International Journal of Clinical Practice published by John Wiley & Sons Ltd.

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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