Liao et al. report a multicentre analysis showing a U-shaped association between pre-ablation BMI and post-ablation atrial tachyarrhythmia recurrence in paroxysmal AF [1]. The work is timely and clinically relevant. From a bedside standpoint, however, using BMI as the sole anthropometric stratifier may limit translation into patient-level decisions. BMI does not capture atrial substrate features linked to recurrence—particularly peri‑left-atrial epicardial adipose tissue (LA-EAT) and fat quality—nor does it distinguish underweight phenotypes such as sarcopenia or cachexia.
