Abstract 12454: Analysis of the Correlation Between the Regional Distribution of Pericardial Fat and the Area of Complex Fractionated Atrial Electrograms during Atrial Fibrillation: Consideration into the Direct Local Effect of Pericardial Fat
Background: Pericardial fat (PF) has been shown to be independently associated with atrial fibrillation (AF). During the pathogenic process of AF, proinflammatory cytokines secreted from PF is postulated to activate fibroblast and thus causes the anatomical remodeling. It has also been suggested that there was a significant correlation between PF and the complex fractionated atrial electrogram (CFAE). However, it is not clear if this pathogenic process caused by PF is conducted through the paracrine or vasocrine signaling pathway.
Objectives: The purpose of this study was to clarify the correlation between regional PF volume and local CFAE area in patients with AF.
Methods: The study population consisted of 30 patients with AF who underwent endocardial mapping of the left atrium (LA) using 3D non-contact mapping system (EnSite 3000) and catheter ablation (27 males and 3 females, meanage; 59 years). PF volume was measured three-dimensionally on the contrast-enhanced images using 64-detector computed tomography. The LA was divided into 5 areas (anterior LA, posterior LA, septal LA, lateral LA, and roof LA). In each LA area, the correlation between the regional PF volume and the regional CFAE area were evaluated.
Results: The total CFAE area positively correlated with the total PF volume within the pericardial sac (p=0.004, r=0.515) and the PF volume within the total LA area (p=0.006, r=0.488). The local PF volumes in anterior LA, posterior LA, septal LA, lateral LA, and roof LA were 8.3±4.2, 2.7±1.6, 4.1±2.2, 5.9±2.8 and 9.0±4.6 cm3, respectively. The regional CFAE area positively correlated with regional PF volume in anterior LA (p=0.022, r=0.417), lateral LA (p=0.037, r=0.382), and LA roof (p=0.007, r=0.481), but was not in the septal LA (p=0.581, r=0.105) and posterior LA (p=0.962, r=0.009), respectively. No significant correlation in the septal and posterior LA may reflect the small pericardial sac area, covers these areas.
Conclusion: A significant correlation between regional PF volume and the regional CFAE area was shown in patients with AF. These findings suggest that PF depots directly related to the genesis of CFAE through the paracrine signaling pathway rather than vasocrine signaling pathway of the proinflammatory cytokines secreted by the PF.
- © 2012 by American Heart Association, Inc.