We read with great interest the article by Liao et al., which reported that both underweight and obese patients are at increased risk of atrial tachyarrhythmia (ATa) recurrence after catheter ablation of paroxysmal atrial fibrillation (PAF) [1]. In a multicentre cohort of 561 patients who underwent pulmonary vein isolation, the authors demonstrated a clear U-shaped relationship between pre-ablation body mass index (BMI) and 12-month recurrence, with optimal cut-offs at 20.0 and 29.14 kg/m². Patients with BMI ≤20.00 or >29.14 kg/m² had approximately twofold and 1.6-fold higher hazards of ATa recurrence, respectively, compared with those in the intermediate BMI range [1].
