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

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.999845

DOI=10.3389/fcvm.2022.999845

ISSN=2297-055X

ABSTRACT=<sec><title>Objectives</title><p>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.</p></sec><sec><title>Methods</title><p>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).</p></sec><sec><title>Results</title><p>Twenty-six cohort studies with 7,878 cases/26,450 individuals were included, and a linear dose-response relationship between BMI and AF recurrence (<italic>P</italic><sub>non–linearity</sub> = 0.12) was found. The risk of AF recurrence in patients with a BMI over 28 was significantly increased. Specifically, for each 5 kg/m<sup>2</sup> increase in BMI, the risk of AF recurrence increased by 15% (95% CI: 1.08–1.22) with moderate heterogeneity (<italic>I</italic><sup>2</sup> = 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.</p></sec><sec><title>Conclusion</title><p>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.</p></sec><sec><title>Systematic review registration</title><p><ext-link ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/PROSPERO/" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/PROSPERO/</ext-link>, identifier CRD42019128770.</p></sec>