Abstract 13123: Role of the Pericardial Fat for the Genesis of Complex Fractionated Atrial Electrograms Region in Atrial Fibrillation
Background: Pericardial fat (PF) has been shown to be independently associated with atrial fibrillation (AF) through the secretion of proinflammatory cytokines which activate fibroblast and cause anatomical remodeling. Meanwhile, complex fractionated atrial electrogram (CFAE) region which was suggested to be caused by the myocardial fibrosis has been shown to be critical for the maintenance of AF. Therefore, we hypothesized that the extent of CFAE may be associated with PF volume.
Objectives: The purpose of this study was to clarify the relation between PFV and area of CFAE in patients with AF.
Methods: The study population included 35 patients with lone AF who underwent catheter ablation (30 males and 5 females, mean age; 59 years). All patients underwent computed tomography before procedure. Total PF volume was measured three-dimensionally on the contrast-enhanced images using 64-detector computed tomography (Brilliance-64, Phillips Medical Systems, Cleveland, OH). The PF volume was defined as any adipose tissue located within the pericardial sac. Endocardial mapping of the left atrium was performed using 3D non-contact mapping system (EnSite 3000) during AF. Then the location and distribution of the CFAE region were identified by non-contact virtual unipolar and virtual bipolar Laplacian electrograms during AF. The area of CFAE region was measured and compared with PF volume.
Results: The mean PF volume was 162.37±56.69 ml. The mean area of CFAE was 22.03±8.32 cm2. The CFAE area positively correlated with PF volume (r=0.709, p<0.001), body weight (r=0.443, p=0.008), body mass index (r=0.376, p=0.026), and waist circumference (r=0.589, p<0.001), but did not with age, gender, AF duration, left atrial diameter, nor left ventricular ejection fraction. The multivariate linear regression analysis revealed that PF volume, but not body weight, body mass index, nor waist circumference independently correlated with the area of CFAE (β=0.709, R2=0.503, p<0.001).
Conclusion: A significant correlation between PF volume and the area of CFAE was shown in patients with AF. These findings suggest that pericardial fat depots directly related to the progression of CFAE area and promote the pathogenic process of AF.
- © 2011 by American Heart Association, Inc.