Pre-ablation Weight Loss Via Metabolic Bariatric Surgery is Associated with Lower In-hospital Complications in Patients with Atrial Fibrillation/flutter.

INTRODUCTION: Obesity is associated with increased risk of in-hospital complications in patients with atrial fibrillation and atrial flutter (AF/AFL). The effects of weight-loss intervention through metabolic bariatric surgery (MBS) remain controversial, as it has been reported to increase in-hospital mortality in AF/AFL patients but also shown to reduce AF recurrence after ablation. We aimed to determine the impact of MBS on short-term outcomes in AF/AFL patients undergoing ablation.

METHODS: This study was conducted using data from the National Inpatient Sample (2016-2022). Patients with a primary diagnosis of AF/AFL who underwent catheter ablation were included. Eligible patients were categorized into four groups: (1) Class I obesity, (2) Class II obesity, (3) Class III obesity, and (4) Pre-ablation weight loss via MBS. Demographics and in-hospital outcomes were analyzed.

RESULTS: In this study, most patients in the obesity groups were males, whereas females predominated in the pre-ablation weight loss group, which also had the lowest comorbidities. The weight loss group had significantly shorter hospital length of stay (LOS) than the other groups and lower incidence of acute kidney injury (vs. Class II-III obesity), acute respiratory syndrome, and infection (vs. Class III obesity). The incidence of cardiac, pericardial complications, and hemorrhage/hematoma did not differ among groups.

CONCLUSION: Pre-ablation weight loss through MBS was associated with short-term benefits in AF/AFL patients after catheter ablation, including reduced in-hospital LOS and complications, particularly among those with Class III obesity, and may help prevent long-term adverse outcomes.