Impact of obesity and prognostic nutritional index on outcomes of ventricular tachycardia ablation in patients with structural heart disease
Abstract
Objectives: Previous studies have demonstrated that nutritional disorders such as obesity and malnutrition are associated with adverse events in patients with a structural heart disease. The impact of these conditions in patients undergoing ventricular tachycardia (VT) ablation is not known. In this study we sought to investigate the effect of obesity and malnutrition on procedural and post-procedural midterm outcomes in patients undergoing VT ablation.
Materials and methods: This is a single center, retrospective study which enrolled patients undergoing structural VT ablation. Patients were classified as normal weight, overweight and obese by body mass index (BMI). Malnutrition was defined as prognostic nutritional score (PNI) < 38. Outcomes between groups were compared.
Results: A total of 203 patients were enrolled to this study. Among these patients, 54 (25.6%) were normal weight, 102 patients (50.2%) were overweight, and 47 patients (23.1%) were obese. 18 patients (8.8%) were classified as malnourished. No significant difference in VT recurrence was observed across BMI (p=0.335) or nutritional status (p=0.556). However, mortality during follow-up was significantly higher in the malnourished group (50% vs. 7%, p<0.001), while BMI showed no significant association with mortality (p=0.202). On multivariate analysis, only PNI <38 (HR 6.659, 95% CI 2.553–17.369, p<0.001) and electrical storm (HR 2.848, 95% CI 1.133–7.160, p=0.026) remained independent predictors of mortality.
Conclusion: This study demonstrated that malnourished patients, as classified by PNI, had significantly worse acute success and higher long-term mortality with similar VT recurrence rate, compared to non-malnourished patients. Obesity status, as defined by BMI, did not lead to different outcomes.
Keywords
catheter ablation, heart failure, malnutrition, obesity, ventricular tachycardia
Supporting Institution
None
References
- Tan NY, Roger VL, Killian JM, et al. Ventricular Arrhythmias Among Patients With Advanced Heart Failure: A Population‐Based Study. J Am Heart Assoc. 2022;11(1):e023377.
- Della Bella P, Baratto F, Vergara P, et al. Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial. Circulation. 2022;145(25):1829–38.
- Tung R, Xue Y, Chen M, et al. First-Line Catheter Ablation of Monomorphic Ventricular Tachycardia in Cardiomyopathy Concurrent With Defibrillator Implantation: The PAUSE-SCD Randomized Trial. Circulation. 2022;145(25):1839–49.
- Esteban-Fernández A, Villar-Taibo R, Alejo M, et al. Diagnosis and Management of Malnutrition in Patients with Heart Failure. J Clin Med. 2023;12(9):3320.
- Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021;143(21):e984-e1010.
- Messerli FH. Overweight and sudden death. Increased ventricular ectopy in cardiopathy of obesity. Arch Intern Med. 1987;147(10):1725–8.
- Adabag S, Huxley RR, Lopez FL, et al. Obesity related risk of sudden cardiac death in the atherosclerosis risk in communities study. Heart. 2015;101(3):215–21.
- Tan MC, Yeo YH, Ang QX, et al. Impact of obesity on catheter ablation of ventricular tachycardia: In-hospital and 30-day outcomes. J Arrhythm. 2023;39(4):672–5.
- Wattanachayakul P, Srikulmontri T, Prasitsumrit V, et al. Malnutrition and risks of atrial fibrillation recurrence after catheter ablation. J Arrhythm. 2025;41(1):e13196.
- Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022;43(40):3997–4126.