A recent analysis of a large nationwide database of patients with atrial fibrillation (AF) who underwent ablation has reported an independent association between being underweight and an increased risk of cardiac tamponade during ablation.
Cardiac tamponade is a potentially fatal complication of catheter ablation for AF, which lead author Reina Tonegawa-Kuji (National Cerebral & Cardiovascular Center, Suita, Japan) and colleagues aimed to evaluate in correlation with body mass index (BMI).
Using a Japanese nationwide claims database, Tonegawa-Kuji et al identified patients who underwent AF ablation between 1 April 2016 and 31 March 2018. The researchers subsequently used mixed-effects multivariable Poisson regression analysis to investigate the hypothesised association between BMI and cardiac tamponade.
A total of 59,789 hospitalisations (age 65.6±10.4 years, 29% women) with catheter ablation for AF were analysed by the researchers, 647 (1.1%) of which reported cardiac tamponade had occurred. Their analysis gleaned that patients who were underweight (BMI <18.5kg/m2) were associated with an increased risk of cardiac tamponade (relative risk [RR]: 1.42; 95% confidence interval [CI]: 1.03–1.95) when compared with having a “normal” weight (BMI ≥18.5 and <25kg/m2).
Other characteristics that were associated with additional risk, Tonegawa-Kuji and colleagues note, were age ≥75 years, female sex, and a history of heart failure, hypertension, diabetes, and dialysis treatment.
The study authors place emphasis on clinicians’ consideration of the higher risk of cardiac tamponade for their underweight patient population, and stress that they “take appropriate measures” to effectively reduce this risk to improve outcomes.