Impact of obesity on procedural safety and 1-year outcomes after pulsed-field ablation for atrial fibrillation

@article{massoullie2026impact,
  title = {{Impact of obesity on procedural safety and 1-year outcomes after pulsed-field ablation for atrial fibrillation}},
  author = {Grégoire Massoullié and Corentin Chaumont and Mikael Laredo and Bruno Pereira and Olivier Thomas and Philippe Maury and Pascal Defaye and Serge Boveda and Eloi Marijon and William Escande and Antoine Roux and Franck Raczka and Yves Guyomar and Pierre Jaïs and Pierre Ollitrault and Mathieu Granier and Samir Fareh and Hugo Marchand and Bertrand Pierre and Selim Abbey and Antoine Noel and Antoine Da Costa and Fabrice Extramiana and Olivier Cesari and Laure Champ-Rigot and Ziad Khoueiry and Thibault Villemin and Sarah Traullé and Frédéric Treguer and Hugues Bader and Jean-Claude Deharo and Bruno Degand and Benoît Guy-Moyat and Didier Klug and Estelle Gandjbakhch and Alexandre Zhao and Maxime Beneyto and Sandrine Venier and Stéphane Combes and Antoine Lepillier and Marc Mielczarek and Nicolas Clementy and Aymeric Menet and Frédéric Sacher and Christian De Chillou and Romain Eschalier and Frédéric Anselme and FRANCE-PFA Registry},
  journal = {Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology},
  year = {2026},
  month = oct,
  doi = {10.1093/europace/euag288},
  url = {https://europepmc.org/article/PMC/PMC13717914},
  note = {CC BY},
}

TY  - JOUR
TI  - Impact of obesity on procedural safety and 1-year outcomes after pulsed-field ablation for atrial fibrillation
AU  - Grégoire Massoullié
AU  - Corentin Chaumont
AU  - Mikael Laredo
AU  - Bruno Pereira
AU  - Olivier Thomas
AU  - Philippe Maury
AU  - Pascal Defaye
AU  - Serge Boveda
AU  - Eloi Marijon
AU  - William Escande
AU  - Antoine Roux
AU  - Franck Raczka
AU  - Yves Guyomar
AU  - Pierre Jaïs
AU  - Pierre Ollitrault
AU  - Mathieu Granier
AU  - Samir Fareh
AU  - Hugo Marchand
AU  - Bertrand Pierre
AU  - Selim Abbey
AU  - Antoine Noel
AU  - Antoine Da Costa
AU  - Fabrice Extramiana
AU  - Olivier Cesari
AU  - Laure Champ-Rigot
AU  - Ziad Khoueiry
AU  - Thibault Villemin
AU  - Sarah Traullé
AU  - Frédéric Treguer
AU  - Hugues Bader
AU  - Jean-Claude Deharo
AU  - Bruno Degand
AU  - Benoît Guy-Moyat
AU  - Didier Klug
AU  - Estelle Gandjbakhch
AU  - Alexandre Zhao
AU  - Maxime Beneyto
AU  - Sandrine Venier
AU  - Stéphane Combes
AU  - Antoine Lepillier
AU  - Marc Mielczarek
AU  - Nicolas Clementy
AU  - Aymeric Menet
AU  - Frédéric Sacher
AU  - Christian De Chillou
AU  - Romain Eschalier
AU  - Frédéric Anselme
AU  - FRANCE-PFA Registry
PY  - 2026
DA  - 2026/10/01
JO  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
DO  - 10.1093/europace/euag288
UR  - https://europepmc.org/article/PMC/PMC13717914
AB  - Aims  Obesity is associated with atrial fibrillation (AF), atrial remodelling, and cardiometabolic comorbidities. Whether baseline body mass index (BMI) influences procedural safety and effectiveness of pulsed-field ablation (PFA) remains uncertain. We evaluated the association of baseline BMI with procedural characteristics, periprocedural safety, and 1-year arrhythmia recurrence after first-time PFA for AF.Methods and results  FRANCE-PFA is a nationwide registry including consecutive patients undergoing first-time AF ablation with a pentaspline PFA catheter. Patients with available BMI were categorized as <25, 25 to <30, 30 to <35, or ≥35 kg/m2. Periprocedural complications and 1-year atrial arrhythmia recurrence were assessed across BMI categories. Among 5223 patients, BMI was available in 4573 (87.6%). Higher BMI was associated with greater cardiometabolic burden, more persistent AF, larger atria, and more extensive ablation strategies, including fewer pulmonary vein isolation-only procedures and more additional lesion sets (all P < 0.001). Periprocedural complications remained infrequent (1.0%), with no significant difference across BMI categories. At 1 year, recurrence was driven mainly by AF type rather than obesity. Within paroxysmal and non-paroxysmal AF, recurrence rates were comparable between patients with BMI < 35 and ≥35 kg/m2 (13.8% vs. 9.1% and 22.9% vs. 23.3%, respectively; log-rank P = 0.925). Severe obesity was not associated with recurrence after multivariable adjustment (HR, 0.86; 95% CI, 0.65-1.14; P = 0.299), with similar findings when BMI was analysed continuously.Conclusion  In this nationwide PFA cohort, higher BMI identified a more advanced AF phenotype and more extensive ablation strategies but was not independently associated with periprocedural complications or 1-year arrhythmia recurrence.
SN  - 1099-5129
SN  - 1532-2092
ER  -