TY - JOUR
T1 - Obesity does not increase complication rate of percutaneous epicardial access
AU - Wan, Siu Hin
AU - Killu, Ammar M.
AU - Hodge, David O.
AU - Packer, Douglas L.
AU - Mulpuru, Siva
AU - Asirvatham, Samuel J.
AU - Munger, Thomas M.
AU - Friedman, Paul A.
N1 - Publisher Copyright:
© 2014 Wiley Periodicals, Inc.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Epicardial Access and Obesity Introduction Percutaneous epicardial access for ablative therapies is an increasingly common technique utilized for refractory ventricular arrhythmias. There are, however few known data on obesity and complication rates associated with this procedure.Methods and Results We retrospectively reviewed the charts of subjects undergoing epicardial access at Mayo Clinic between January 2004 and June 2013. Baseline clinical and echocardiographic data were collected for each subject, who was then classified into body mass index (BMI) categories as underweight, normal weight, overweight, and obese based on a BMI of <18.5, 18.5-24.99, 25-29.99, and ≥30, respectively. Events and complications were recorded, and procedural and clinical success rates were determined. There was no statistically significant difference in access approach, procedural or clinical outcomes, or complications among the BMI categories. Note that 95.1%, 91.7%, and 93.1% derived procedural success among the normal weight, overweight, and obese categories, respectively (P value = 0.81). Similarly, there was no difference in clinical outcomes with success rates of 68.3%, 66.7%, and 75.9% between the respective groups (P value = 0.54). At 5 years, there was a trend toward increased mortality among obese individuals (28.8%) compared to normal weight (8.8%) and overweight (9.8%) patients (P value = 0.139).Conclusion Percutaneous epicardial access, mapping, and ablation can be performed in obese individuals with similar outcomes to those of lower weight category. Obesity should not preclude the use of percutaneous epicardial access when clinically indicated.
AB - Epicardial Access and Obesity Introduction Percutaneous epicardial access for ablative therapies is an increasingly common technique utilized for refractory ventricular arrhythmias. There are, however few known data on obesity and complication rates associated with this procedure.Methods and Results We retrospectively reviewed the charts of subjects undergoing epicardial access at Mayo Clinic between January 2004 and June 2013. Baseline clinical and echocardiographic data were collected for each subject, who was then classified into body mass index (BMI) categories as underweight, normal weight, overweight, and obese based on a BMI of <18.5, 18.5-24.99, 25-29.99, and ≥30, respectively. Events and complications were recorded, and procedural and clinical success rates were determined. There was no statistically significant difference in access approach, procedural or clinical outcomes, or complications among the BMI categories. Note that 95.1%, 91.7%, and 93.1% derived procedural success among the normal weight, overweight, and obese categories, respectively (P value = 0.81). Similarly, there was no difference in clinical outcomes with success rates of 68.3%, 66.7%, and 75.9% between the respective groups (P value = 0.54). At 5 years, there was a trend toward increased mortality among obese individuals (28.8%) compared to normal weight (8.8%) and overweight (9.8%) patients (P value = 0.139).Conclusion Percutaneous epicardial access, mapping, and ablation can be performed in obese individuals with similar outcomes to those of lower weight category. Obesity should not preclude the use of percutaneous epicardial access when clinically indicated.
KW - atrial fibrillation
KW - electrophysiology
KW - epicardial access
KW - mortality
KW - obesity
KW - rehospitalization
KW - ventricular tachycardia
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U2 - 10.1111/jce.12485
DO - 10.1111/jce.12485
M3 - Article
C2 - 25065419
AN - SCOPUS:84911994783
SN - 1045-3873
VL - 25
SP - 1174
EP - 1179
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
IS - 11
ER -