Obese Patients May Benefit the Most From Surgery for Irregular Heartbeat

They reported the greatest gains in quality of life, study finds

By Denise Mann
HealthDay Reporter

FRIDAY, Dec. 9 (HealthDay News) -- Overweight or obese individuals who undergo a procedure to treat an irregular heartbeat known as atrial fibrillation may see greater improvements in their quality of life after the treatment than their thinner counterparts.

The findings appear in the December edition of the journal HeartRhythm.

Atrial fibrilation (AF) greatly increases a person's risk for stroke. Many people with AF are treated with medications to help lower this risk. An alternative to medication, catheter ablation, treats AF by placing a thin tube (catheter) in the heart and burning off the tissue or pathways that are responsible for irregular heartbeat.

In the study, 79 percent of 660 participants were overweight or obese. The ablation procedure was equally successful at controlling the AF in both thin and heavyset individuals, but those who were obese and overweight showed greater gains in their quality of life. They did report a lower quality of life before the procedure than their thinner counterparts.

One year after the procedure, the overweight and obese participants reported feeling they had fewer limitations due to their physical health and emotional problems. They also reported increased vitality and less anxiety and depression after the procedure. By contrast, people with a normal body-mass index did not show "substantial" improvements in their quality of life after ablation.

"We have some reassuring news for the obese population because we are reporting improvements in quality of life when they undergo ablation for AF," said study author Dr. Sanghamitra Mohanty, a cardiologist at St. David's Medical Center in Austin, Texas. "However, this paper does not attempt to trivialize the importance of weight control," she said. Obesity is also a risk factor for AF and other diseases.

The findings touch on the so-called "obesity paradox," a phenomenon that shows that people who are obese may face a lower risk of death and complications after certain procedures than their thinner counterparts despite the known risks associated with the extra weight.

Most people with AF are treated with medications to control the abnormal heart rhythm and/or lower their risk for stroke. The new study could not say whether obese or overweight people could also expect a better quality of life if they are treated with medication over ablation. There is no data on how many ablation procedures to treat AF are performed yearly in the United States, but Mohanty and colleagues do about 1,600 a year at St. David's Medical Center.

Ablation does have some pluses when it comes to treating AF, said Dr. Robert Myerburg, a cardiology professor at the University of Miami School of Medicine. "It is good for people who have failed medication therapy, and does offer the hope of a permanent or near permanent cure. It's not a last resort, but another option in the treatment of AF."

As to the latest findings, "people who are obese and have successful ablation have a better quality of life than who are not obese," he said. They may have more to gain from the procedure in the first place, he noted, adding that the findings may not hold for people who are severely obese.

More information

Learn how AF is treated at the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Robert Myerburg, M.D., cardiology professor, University of Miami School of Medicine, Miami; Sanghamitra Mohanty, M.D., cardiologist, St. David's Medical Center, Austin, Texas; December 2011 HeartRhythm

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