Department of Cardiology, The Seventh People's Hospital, Zhengzhou, Henan, China.
Department of Anesthesiology, The People's Hospital of Shangrao, Jiangxi, China.
Clin Cardiol. 2020 Oct;43(10):1067-1075. doi: 10.1002/clc.23398. Epub 2020 Jun 3.
The association of body mass index (BMI) and procedure-related factors in patients with atrial fibrillation (AF) after radiofrequency ablation (RFA) is still unclear.
BMI is associated with increased the radiation dose, procedure duration, and procedural complications.
Prospective studies assessing BMI and procedure duration, radiation dose, and procedural complications in patients with AF after RFA were identified through electronic searches of PubMed, Embase, and the Cochrane Library database.
Ten studies with 14 735 participants undergoing RFA were included. Procedure duration was significantly longer in patients with overweight or obesity than in patients with normal BMI, with a mean difference (MD) of 0.95. Patients with overweight and obesity were exposed to a larger radiation dose, with standard MD of 1.71 and 1.98, respectively. There was no significant association between overweight or obesity and the risk of procedural complications (RR of 0.91 for overweight, 1.01 for obesity, 0.89 for stage I obesity, 1.00 for stage II obesity, and 0.94 for stage III obesity). Further analysis showed there was no significant difference regarding stroke or transient ischemic attack (overweight, RR: 0.92; obesity, RR: 1.02); cardiac tamponade (overweight, RR: 0.92; obesity, RR: 1.02); groin hematoma (overweight, RR: 0.62; obesity, RR: 0.40); or pulmonary vein stenosis (overweight, RR: 0.49; obesity, RR: 0.40) among BMI groups.
Based on available evidence, we first showed that patients with overweight/obesity undergoing RFA experienced a significantly increased procedure duration and received a larger radiation dose than patients with normal BMI; however, there was no significant difference in procedural complications between patients with overweight/obesity and patients with normal BMI.
体重指数（BMI）与接受射频消融（RFA）后心房颤动（AF）患者的程序相关因素之间的关联尚不清楚。
BMI 与增加辐射剂量、程序持续时间和程序并发症相关。
通过电子搜索 PubMed、Embase 和 Cochrane 图书馆数据库，确定了评估 RFA 后 AF 患者 BMI 与程序持续时间、辐射剂量和程序并发症的前瞻性研究。
纳入了 10 项研究，共 14735 名接受 RFA 的患者。超重或肥胖患者的程序持续时间明显长于正常 BMI 患者，平均差异（MD）为 0.95。超重和肥胖患者接受的辐射剂量较大，标准 MD 分别为 1.71 和 1.98。超重或肥胖与程序并发症的风险之间没有显著关联（超重的 RR 为 0.91，肥胖的 RR 为 1.01，I 期肥胖的 RR 为 0.89，II 期肥胖的 RR 为 1.00，III 期肥胖的 RR 为 0.94）。进一步分析显示，在中风或短暂性脑缺血发作（超重，RR：0.92；肥胖，RR：1.02）、心脏压塞（超重，RR：0.92；肥胖，RR：1.02）、腹股沟血肿（超重，RR：0.62；肥胖，RR：0.40）或肺静脉狭窄（超重，RR：0.49；肥胖，RR：0.40）方面，BMI 组之间没有显著差异。
基于现有证据，我们首次表明，与 BMI 正常的患者相比，接受 RFA 的超重/肥胖患者的程序持续时间明显延长，接受的辐射剂量也更大；然而，超重/肥胖患者与 BMI 正常患者的程序并发症之间没有显著差异。
