We read with great interest the article by Liao et al. titled “Both underweight and obese patients are prone to relapse after ablation of paroxysmal atrial fibrillation” published in the European Journal of Internal Medicine [1]. The authors identified a clinically meaningful U-shaped relationship between body mass index (BMI) and arrhythmia recurrence after pulmonary vein isolation (PVI), filling a critical gap in prior research by highlighting the underrecognized recurrence risk in underweight patients—an overlooked cohort in cardiovascular studies.
