Sex-specific impact of body mass index on recurrence of atrial fibrillation after catheter ablation

Background Sex-specific differences in the clinical outcome of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) remain controversial. The impact of body mass index (BMI) on sex-based variation in the outcome of PVI is not well understood. Objective We sought to investigate the impact of BMI with associated atrial conduction indices (ACI) on sex-specific differences in AF recurrence after PVI. Methods All consecutive patients who underwent first PVI for AF from 2014 to 2019 were included. ACI were measured on surface electrocardiogram (ECG) and intracardiac electrogram (EGM). Data was collected and analyzed based on BMI and sex. Results The study included 387 patients with AF (121 women and 266 men; mean age 66 years; 49.2% with BMI ≥30). Women were older at the time of the procedure (median age 67 versus 62 years, P0.05). Post-PVI atrial flutter (AFL) occurred more often in women (21.5% versus 10.9%, P=0.009). Female sex, enlarged left atria, prolonged ACI, and post-PVI AFL were predictors of AF recurrence (P