Exploratory Phase Angle Assessment After Atrial Fibrillation Ablation in Overweight Patients: A Pilot Study

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. 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 atrial tachyarrhythmia ≥ 30 seconds beyond a 3-month blanking period, confirmed by ECG or Holter monitoring. Results Five patients experienced AF recurrence (PEF group), while eight maintained sinus rhythm (NSR group). Overall, no significant changes were observed in the total cohort. However, subgroup analysis demonstrated divergent changes in body composition. The NSR group showed significant 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-ablation recovery. Trial registration: not applicable