Utilization and in-hospital complications of catheter ablation for atrial fibrillation in patients with obesity and morbid obesity

Background: Real-world data on atrial fibrillation (AF) ablation outcomes in obese populations have remained scarce, especially the relationship between obesity and in-hospital AF ablation outcome.

Hypothesis: Obesity is associated with higher complication rates and higher admission trend for AF ablation.

Methods: We drew data from the US National Inpatient Sample to identify patients who underwent AF ablation between 2005 and 2018. Sociodemographic and patients' characteristics data were collected, and the trend, incidence of catheter ablation complications and mortality were analyzed, and further stratified by obesity classification.

Results: A total of 153 429 patients who were hospitalized for AF ablation were estimated. Among these, 11 876 obese patients (95% confidence interval [CI]: 11 422-12 330) and 10 635 morbid obese patients (95% CI: 10 200-11 069) were observed. There was a substantial uptrend admission, up to fivefold, for AF ablation in all obese patients from 2005 to 2018 (p < .001). Morbidly obese patients were statistically younger, while coexisting comorbidities were substantially higher than both obese and nonobese patients (p < .01) Both obesity and morbid obesity were significantly associated with an increased risk of total bleeding, and vascular complications (p < .05). Only morbid obesity was significantly associated with an increased risk of ablation-related complications, total infection, and pulmonary complications (p < .01). No difference in-hospital mortality was observed among obese, morbidly obese, and nonobese patients.

Conclusion: Our study observed an uptrend in the admission of obese patients undergoing AF ablation from 2005 through 2018. Obesity was associated with higher ablation-related complications, particularly those who were morbidly obese.