We read with great interest the recent article by Liao et al., entitled “Both underweight and obese patients are prone to relapse after ablation of paroxysmal atrial fibrillation” [1]. The authors should be congratulated for conducting a large, multicentre, multinational analysis addressing the U-shaped relationship between body mass index (BMI) and atrial tachyarrhythmia recurrence following paroxysmal atrial fibrillation (PAF) ablation. This work adds valuable evidence to the growing recognition that both metabolic excess and deficiency may predispose to atrial substrate instability.
