{Reference Type}: Journal Article
{Title}: Epicardial adipose tissue volume assessed by cardiac CT as a predictor of atrial fibrillation recurrence following catheter ablation.
{Author}: Teixeira BL;Cunha PS;Jacinto AS;Portugal G;Laranjo S;Valente B;Lousinha A;Cruz MC;Delgado AS;Brás M;Paulo M;Guerra C;Ramos R;Fontes I;Ferreira RC;Oliveira MM;
{Journal}: Clin Imaging
{Volume}: 110
{Issue}: 0
{Year}: 2024 Jun 28
{Factor}: 2.42
{DOI}: 10.1016/j.clinimag.2024.110170
{Abstract}: <B>BACKGROUND: </B>In patients with atrial fibrillation (AF), up to one third have recurrence after a first catheter ablation (CA). Epicardial adipose tissue (EAT) has been considered to be closely related to AF, with a potential role in its recurrence. We aimed to evaluate the association between the volume of EAT measured by cardiac computed tomography (CT) and AF recurrence after CA.<BR><B>METHODS: </B>Consecutive AF patients underwent a standardized cardiac CT protocol for quantification of EAT, thoracic adipose volume (TAV) and left atrium (LA) volume before CA. An appropriate cut-off of EAT was determined and risk recurrence was estimated.<BR><B>RESULTS: </B>305 patients (63.6 % male, mean age 57.5 years, 28.2 % persistent AF) were followed for 24 months; 23 % had AF recurrence at 2-year mark, which was associated with higher EAT (p = 0.037) and LAV (p < 0.001). Persistent AF was associated with higher EAT volumes (p = 0.010), TAV (p = 0.003) and LA volumes (p < 0.001). EAT was predictive of AF recurrence (p = 0.044). After determining a cut-off of 92 cm3, survival analysis revealed that EAT volumes > 92 cm3 showed higher recurrence rates at earlier time points after the index ablation procedure (p = 0.006), with a HR of 1.95 (p = 0.008) of AF recurrence at 2-year. After multivariate adjustment, EAT > 92 cm3 remained predictive of AF recurrence (p = 0.028).<BR><B>CONCLUSIONS: </B>The volume of EAT measured by cardiac CT can predict recurrence of AF after ablation, with a volume above 92 cm3 yielding almost twice the risk of arrhythmia recurrence in the first two years following CA. Higher EAT and TAV are also associated with persistent AF.