Metabolic syndrome and risk of recurrence of atrial fibrillation after catheter ablation

Ri-Bo Tang, Jian-Zeng Dong, Xing-Peng Liu, De-Yong Long, Rong-Hui Yu, Jérôme Kalifa, Chang-Sheng Ma
Circulation Journal: Official Journal of the Japanese Circulation Society 2009, 73 (3): 438-43

BACKGROUND: Metabolic syndrome (MetS), as well as several risk factors of cardiovascular diseases, is known to be associated with atrial fibrillation (AF), but its impact on the recurrence of AF after catheter ablation has not been explored.

METHODS AND RESULTS: The data for 654 consecutive AF patients who underwent an index circumferential pulmonary vein ablation were retrospectively analyzed. Of them, 323 (49.4%) had MetS according to the modified National Cholesterol Education Program-Adult Treatment Panel III criteria and Chinese ethnic criteria. After a mean follow-up of 470+/-323 (91-1,245) days, patients with MetS had a significantly higher incidence of AF recurrence (43.7%) compared with non-MetS patients (30.5%, P<0.001). Univariate analysis revealed that nonparoxysmal AF, left atrial size, MetS and body mass index were predictors of AF recurrence. Multivariate analysis revealed that MetS (hazard ratio =1.64, 95% confidence interval (CI) 1.07-2.49, P=0.022) and nonparoxysmal AF (hazard ratio =1.57, 95% CI 1.15-2.14, P=0.004) were independent predictors of AF recurrence. The major complications rate did not differ between the MetS and the non-MetS groups (1.86% vs 2.42%, P=0.621).

CONCLUSIONS: MetS diagnosed prior to AF ablation is an independent predictor of AF recurrence.

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