Abstract 16584: Epicardial Adipose Tissue Surrounding the Left Atrium Predicts the Recurrence of Atrial Fibrillation after Catheter Ablation
Introduction: Epicardial adipose tissue (EAT) contains abundant ganglionated plexi contributing to the occurrence of atrial fibrillation (AF).We sought to investigate the relationship between the outcomes of ablation and the structures in addition to EAT of left atrium (LA) using the multi-detector computed tomographic (MDCT) images.
Method: We evaluated the EAT around LA and the sizes and ejection fraction (EF) of pulmonary veins (PV), LA by the baseline 64-slice MDCT.The EAT was measured by assigning Hounsfield units from −50 to −200 to fat, and the axial images from the pulmonary artery to the coronary sinus were traced at atrial end-diastole. The distribution of EAT was evaluated by 8 regions surrounding LA.
Results: Forty-one AF patients and 19 controls were included. The age, gender, body mass index and CAD were similar. The volume of the EAT increased significantly in patients with AF as compared to controls (28.93±12.68 vs. 20.40±7.33 cm3, p<0.01). The AF patients were categorized into two groups by the ablation outcomes. Group I: 13 patients with AF recurrence; group II: 28 patients without recurrence. The amount of EAT was significantly more in group I (35.20±14.84 vs. 25.91±10.50 cm3, p=0.023). Regional analysis showed the fat adjacent to the right roof of LA (11.22±3.34 vs. 7.58±3.33 cm3, p=0.04) and the area between left inferior PV and atrioventricular groove (6.00±2.67 vs. 4.27±2.68 cm3, p=0.036) were significantly increased in Group I (figure 1A and B). The other structural parameters, including sizes of right and left superior PV (p=0.55, 0.94 respectively), LA (p=0.94) and EF of PV (p=0.17, 0.20 respectively), LA (p=0.45) were similar between two groups.
Conclusion: EAT surrounding LA was increased in patients with AF. Furthermore, the ”fatty atrium” was the only one anatomic parameter related to the recurrence of AF after catheter ablation. This finding may confer the information for better understanding of the role of EAT in AF.
- © 2010 by American Heart Association, Inc.