Body mass index and atrial fibrillation recurrence post ablation: A systematic review and dose-response meta-analysis

Fuwei Liu; Tiangang Song; Qingwen Hu; Xin Zhu; Huilei Zhao; Ziqi Tan; Peng Yu; Jianyong Ma; Jun Luo; Xiao Liu

doi:10.3389/fcvm.2022.999845

Body mass index and atrial fibrillation recurrence post ablation: A systematic review and dose-response meta-analysis

Front Cardiovasc Med. 2023 Feb 2:9:999845. doi: 10.3389/fcvm.2022.999845. eCollection 2022.

Authors

Fuwei Liu¹, Tiangang Song², Qingwen Hu², Xin Zhu³, Huilei Zhao⁴, Ziqi Tan², Peng Yu², Jianyong Ma⁵, Jun Luo¹, Xiao Liu¹

Affiliations

¹ Department of Cardiology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China.
² Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
³ Department of Cardiology, The First People's Hospital of Yulin, Yulin, Guangxi, China.
⁴ Department of Anesthesia, The Third People's Hospital of Nanchang, Nanchang, Jiangxi, China.
⁵ Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States.

Abstract

Objectives: The aim of this study was to evaluate the shape of the dose-response relationship between body mass index (BMI) and atrial fibrillation (AF) recurrence in patients who have undergone radiofrequency ablation.

Methods: Studies investigating BMI and AF recurrence in patients with AF after ablation were identified through electronic searches in the PubMed, EMBASE, and Cochrane Library databases. The potential non-linear relationship was fitted using robust error meta-regression. Our study was registered with PROSPERO (CRD42019121373).

Results: Twenty-six cohort studies with 7,878 cases/26,450 individuals were included, and a linear dose-response relationship between BMI and AF recurrence (P _{non-linearity} = 0.12) was found. The risk of AF recurrence in patients with a BMI over 28 was significantly increased. Specifically, for each 5 kg/m² increase in BMI, the risk of AF recurrence increased by 15% (95% CI: 1.08-1.22) with moderate heterogeneity (I ² = 53%). Subgroup analyses showed that the pooled risk ratio was not significantly changed in subgroup analysis adjustment for the following important potential intermediate factors: left atrial diameter and obstructive sleep apnea.

Conclusion: This study showed that there is a borderline positive linear association between BMI and AF recurrence post ablation. Overweight and obesity are significantly associated with AF recurrence.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42019128770.

Keywords: atrial fibrillation; body mass index; exposure-effect; meta-analysis; obesity; radiofrequency ablation.

Publication types

Systematic Review

Grants and funding

This work was supported by the National Natural Science Foundation of China (Nos. 81760050, 81760048, 82100347, and 8210020907), the Jiangxi Provincial Natural Science Foundation for Youth Scientific Research (No. 20192ACBL21037), and China Postdoctoral Science Foundation (No. 2021M703724).