PDF(Pubmed)
Abstract：
(1)Introduction: Catheter ablation has become a cornerstone for the management of patients with atrial fibrillation (AF). Nevertheless, recurrence rates remain high. Epicardial adipose tissue (EAT) has been associated with AF pathogenesis and maintenance. However, the literature has provided equivocal results regarding the relationship between EAT and post-ablation recurrence.(2) Purpose: to investigate the relationship between total and peri-left atrium (peri-LA) EAT with post-ablation AF recurrence. (3) Methods: major electronic databases were searched for articles assessing the relationship between EAT, quantified using computed tomography, and the recurrence of AF following catheter ablation procedures. (4) Results: Twelve studies (2179 patients) assessed total EAT and another twelve (2879 patients) peri-LA EAT. Almost 60% of the included patients had paroxysmal AF and recurrence was documented in 34%. Those who maintained sinus rhythm had a significantly lower volume of peri-LA EAT (SMD: -0.37, 95%; CI: -0.58-0.16, I2: 68%). On the contrary, no significant difference was documented for total EAT (SMD: -0.32, 95%; CI: -0.65-0.01; I2: 92%). No differences were revealed between radiofrequency and cryoenergy pulmonary venous isolation. No publication bias was identified. (5) Conclusions: Only peri-LA EAT seems to be predictive of post-ablation AF recurrence. These findings may reflect different pathophysiological roles of EAT depending on its location. Whether peri-LA EAT can be used as a predictor and target to prevent recurrence is a matter of further research.
摘要：
（1）简介：导管消融已成为房颤（AF）患者管理的基石。然而，复发率仍然很高。心外膜脂肪组织(EAT)与AF发病机制和维持相关。然而,关于EAT与消融后复发之间的关系,文献提供了模棱两可的结果.（2）目的：探讨全心房和左心房周围（peri-LA）EAT与消融后房颤复发的关系。(3)方法:检索主要电子数据库中评价EAT与EAT、使用计算机断层扫描量化，导管消融术后房颤复发。（4）结果：12项研究（2179名患者）评估了总EAT，另外12项（2879名患者）评估了LA周围EAT。几乎60%的纳入患者有阵发性房颤，34%的患者有复发记录。维持窦性心律的患者LA周围EAT的体积明显较低（SMD：-0.37，95％；CI：-0.58-0.16，I2：68％）。相反,总EAT无显著差异(SMD:-0.32,95%;CI:-0.65-0.01;I2:92%).射频和冷冻能量肺静脉隔离之间没有差异。未发现发表偏倚。（5）结论：似乎只有LA周围EAT可以预测消融后AF复发。这些发现可能反映了EAT的不同病理生理作用，具体取决于其位置。LA周围EAT是否可以用作预防复发的预测和目标是进一步研究的问题。
