IMR Press / RCM / Volume 22 / Issue 3 / DOI: 10.31083/j.rcm2203114
Open Access Original Research
Influence of excess weight and obesity on performance and outcome of pulmonary vein isolation with the cryoballoon
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1 Department of Cardiology, Heart Centre Niederrhein, Helios Clinic Krefeld, 47805 Krefeld, Germany
2 Witten-Herdecke University, 58455 Witten, Germany
3 Department of Cardiology, Petrus Hospital, 42283 Wuppertal, Germany
4 Department of Cardiology, Helios University Hospital, 42283 Wuppertal, Germany
Academic Editor: Yoshiaki Kaneko
Rev. Cardiovasc. Med. 2021, 22(3), 1047–1052;
Submitted: 8 July 2021 | Revised: 20 August 2021 | Accepted: 23 August 2021 | Published: 24 September 2021
(This article belongs to the Special Issue Clinical Electrophysiology: Diagnosis and Treatment)

Pulmonary vein isolation (PVI) has become a cornerstone therapy in the treatment of atrial fibrillation (AF). Patients with overweight or obesity suffer more often from AF, and studies investigating the safety and feasibility of PVI in these patients have shown varying results. In this study we analyzed PVI performed with the 2nd generation cryoballoon (CB) with regard to safety, procedure and fluoroscopy time in patients with normal weight, overweight and obesity. We analyzed 228 consecutive patients treated with CB PVI in our hospital in 2018 and 2019. Fifty nine (25.88%) patients presented with normal weight (body mass index (BMI) of <25), 115 (50.44%) patients with overweight (BMI between 25 and 29.9) and 54 (23.68%) were obese patients (BMI >30). All pulmonary veins (PV) were isolated successfully. Concerning procedural parameters, neither complications, procedural time, nor fluoroscopy time differed significantly. There was a significant increase of dose area product (DAP) in obese patients compared to normal weight and overweight patients (2035.5 ± 1930.1 μGym2 vs. 975.3 ± 814.9 vs. 1325.1 ± 2081.3, p = 0.001) but no significant difference between overweight and normal weight patients (p = 0.611). Our follow-up data of 168 patients (73.68%) observed for 12 months showed no differences in the recurrence of AF in the three BMI groups [80.9% vs. 83.3% (p = 0.733) vs. 86.55% (p = 0.460)]. In conclusion, CB PVI in overweight and obese patients is safe with similar levels of complications and recurrence of AF as patients of normal weight. However, obese patients and operators are exposed to higher radiation doses.

Arial fibrillation
Fig. 1.
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