Abstract
BACKGROUND: The phase angle (PhA), derived from bioelectrical impedance analysis (BIA), is an indicator of cellular health and nutritional status. Its role in patients with atrial fibrillation (AF), particularly after catheter ablation, is not well-established. This study aimed to investigate changes in PhA and their correlation with cardiac remodeling in overweight patients with persistent AF after cryoballoon ablation. METHODS: Thirteen overweight patients (BMI ≥ 23 kg/m²) with persistent AF scheduled for ablation were prospectively enrolled. One patient was excluded due to sick sinus syndrome requiring pacemaker implantation; thus, final analyses were performed on 12 patients. Baseline clinical, echocardiographic, and BIA parameters were collected. At 6 months, follow-up data were available for 12 patients. AF recurrence was defined as any documented atrial tachyarrhythmia ≥ 30 s beyond a 3-month blanking period, confirmed by ECG or Holter monitoring. RESULTS: Five patients experienced AF recurrence (PEF group), while seven maintained sinus rhythm (NSR group). Overall changes were modest; ECW/TBW was significant but numerically minimal, with no significant changes in other parameters. However, subgroup analysis demonstrated divergent changes in body composition. The NSR group showed substantial improvements in intracellular water and phase angle values, whereas the PEF group exhibited consistent declines (p < 0.05 for group comparisons). CONCLUSION: These preliminary findings suggest that successful rhythm control after ablation may be associated with systemic recovery reflected by BIA-derived parameters. Larger, multicenter studies incorporating functional and clinical outcomes are warranted to validate the potential role of PhA as a biomarker for post-AF ablation recovery. TRIAL REGISTRATION: Not applicable.