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Biomedicines
Volume 13
Issue 2
10.3390/biomedicines13020298
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Systematic Review

Cryoballoon Pulmonary Vein Isolation in Obese Patients with Atrial Fibrillation Compared to Non-Obese Counterparts: A Meta-Analysis

by
Dimitrios A. Vrachatis
1,2,†,
Konstantinos A. Papathanasiou
3,*,†,
Dimitrios Kazantzis
4,
Ioannis Anagnostopoulos
1,
Maria Kousta
1,
Sotiria G. Giotaki
1,
Gerasimos Deftereos
1,
Vaia Lambadiari
5,
George Giannopoulos
6,
Efthimia K. Basdra
1,7,
Theodore G. Papaioannou
2,
Gerasimos Siasos
8 and
Spyridon Deftereos
1,3
1
Eugenideio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
2
Department of Biomedical Engineering, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
3
Second Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Attikon University Hospital, 12462 Athens, Greece
4
NIHR Moorfields Biomedical Research Centre and Clinical Research Facility, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
5
Second Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Attikon University Hospital, 12462 Athens, Greece
6
Third Department of Cardiology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
7
Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
8
Third Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, 11527 Athens, Greece
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Biomedicines 2025, 13(2), 298; https://doi.org/10.3390/biomedicines13020298
Submission received: 24 December 2024 / Revised: 18 January 2025 / Accepted: 22 January 2025 / Published: 25 January 2025
(This article belongs to the Section Molecular and Translational Medicine)
Versions Notes

Abstract

Introduction: Obesity is an important risk factor for atrial fibrillation (AF) development. Data on cryoballoon ablation (CBA) outcomes in obese patients have so far been scarce. We reviewed the existing literature to compare the efficacy and safety of CBA in obese versus non-obese AF patients. Methods: A systematic literature search was conducted for studies comparing clinical outcomes (arrhythmia recurrence and/or procedural data and/or safety outcomes) between obese and non-obese patients undergoing CBA for AF. Statistical pooling was performed according to a random-effects model with generic inverse-variance weighting of relative risks (RRs) and standardised mean differences (SMDs) computing risk estimates with 95% confidence intervals (CIs). Results: Obese and non-obese patients had comparable arrhythmia recurrence rates (normal versus overweight, RR = 0.95, 95% CI: 0.82–1.11, p = 0.55, I2% = 91%; normal versus class I obesity, RR = 0.97, 95% CI: 0.82–1.13, p = 0.68, I2% = 87%; normal versus class II obesity, RR = 0.98, 95% CI: 0.91–1.07, p = 0.29, I2% = 65%). Procedure time was marginally increased in obese patients compared to non-obese counterparts (normal versus overweight, SMD = 0.05, 95% CI: −0.15–0.26, p = 0.62, I2% = 74%; normal versus class I obesity, SMD = 0.10, 95% CI: −0.00–0.19, p = 0.06, I2% = 2%; overweight versus class I obesity, SMD = 0.11, 95% CI: 0.01–0.21, p = 0.048, I2% = 25%). Regarding radiation exposure, fluoroscopy time was increased in patients with class I obesity compared to normal-weight or overweight patients and dose area product was also increased in obese patients compared to non-obese patients. Lastly, the risk of complications did not differ between obese and non-obese patients. Statistical heterogeneity and the small number of patients included are the main limitations of this study. Conclusion: CBA seems to be effective for obese patients suffering from AF, featuring also similar safety outcomes with non-obese individuals. Radiation exposure was increased in obese patients.
Keywords: atrial fibrillation; obesity; body mass index; catheter ablation; arrhythmia recurrence; radiation exposure atrial fibrillation; obesity; body mass index; catheter ablation; arrhythmia recurrence; radiation exposure

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MDPI and ACS Style

Vrachatis, D.A.; Papathanasiou, K.A.; Kazantzis, D.; Anagnostopoulos, I.; Kousta, M.; Giotaki, S.G.; Deftereos, G.; Lambadiari, V.; Giannopoulos, G.; Basdra, E.K.; et al. Cryoballoon Pulmonary Vein Isolation in Obese Patients with Atrial Fibrillation Compared to Non-Obese Counterparts: A Meta-Analysis. Biomedicines 2025, 13, 298. https://doi.org/10.3390/biomedicines13020298

AMA Style

Vrachatis DA, Papathanasiou KA, Kazantzis D, Anagnostopoulos I, Kousta M, Giotaki SG, Deftereos G, Lambadiari V, Giannopoulos G, Basdra EK, et al. Cryoballoon Pulmonary Vein Isolation in Obese Patients with Atrial Fibrillation Compared to Non-Obese Counterparts: A Meta-Analysis. Biomedicines. 2025; 13(2):298. https://doi.org/10.3390/biomedicines13020298

Chicago/Turabian Style

Vrachatis, Dimitrios A., Konstantinos A. Papathanasiou, Dimitrios Kazantzis, Ioannis Anagnostopoulos, Maria Kousta, Sotiria G. Giotaki, Gerasimos Deftereos, Vaia Lambadiari, George Giannopoulos, Efthimia K. Basdra, and et al. 2025. "Cryoballoon Pulmonary Vein Isolation in Obese Patients with Atrial Fibrillation Compared to Non-Obese Counterparts: A Meta-Analysis" Biomedicines 13, no. 2: 298. https://doi.org/10.3390/biomedicines13020298

APA Style

Vrachatis, D. A., Papathanasiou, K. A., Kazantzis, D., Anagnostopoulos, I., Kousta, M., Giotaki, S. G., Deftereos, G., Lambadiari, V., Giannopoulos, G., Basdra, E. K., Papaioannou, T. G., Siasos, G., & Deftereos, S. (2025). Cryoballoon Pulmonary Vein Isolation in Obese Patients with Atrial Fibrillation Compared to Non-Obese Counterparts: A Meta-Analysis. Biomedicines, 13(2), 298. https://doi.org/10.3390/biomedicines13020298

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