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European Radiology
Published in: European Radiology 8/2015

01-08-2015 | Cardiac

Increased epicardial fat is independently associated with the presence and chronicity of atrial fibrillation and radiofrequency ablation outcome

Authors: Jadranka Stojanovska, Ella A. Kazerooni, Mohamad Sinno, Barry H. Gross, Kuanwong Watcharotone, Smita Patel, Jon A. Jacobson, Hakan Oral

Published in: European Radiology | Issue 8/2015

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Abstract

Objective

To determine whether intrathoracic fat volumes are associated with presence and chronicity of atrial fibrillation (AF) and radiofrequency ablation (RFA) treatment outcome.

Methods

IRB approval was obtained and patient consent was waived for this HIPAA-compliant retrospective study. 169 patients with AF (75 non-paroxysmal and 94 paroxysmal) and 62 control patients underwent cardiac CT examination. Extrapericardial (EPFV) and epicardial fat volumes (EFV) were measured on CT, the sum of which is the total intrathoracic fat volume. Associations between these three fat volumes and presence and chronicity of AF, and outcome after RFA, were evaluated using logistic regression analysis.

Results

EFV was significantly associated with presence [OR 1.01 (95 % CI 1.003–1.03), p = 0.01], chronicity of AF [1.008 (1.001–1.020), p = 0.03] and AF recurrence after RFA [1.009 (1.001–1.01), p = 0.02] after adjustment for age, gender and BMI. Patients with a larger EFV had a shorter time to AF recurrence (p = 0.017) and a higher rate of recurrence (54 % vs 46 %) (p = 0.002) after RFA. EPFV had no significant associations.

Conclusion

Increased epicardial fat is associated with the presence and chronicity of AF, a higher probability of AF recurrence after RFA and a shorter AF-free interval.

Key Points

• Increased epicardial fat is associated with presence and chronicity of atrial fibrillation
• Extensive epicardial fat is associated with earlier recurrences of AF after ablation
• Extensive epicardial fat may reduce transmurality of ablation by affecting current dynamics
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Metadata
Title
Increased epicardial fat is independently associated with the presence and chronicity of atrial fibrillation and radiofrequency ablation outcome
Authors
Jadranka Stojanovska
Ella A. Kazerooni
Mohamad Sinno
Barry H. Gross
Kuanwong Watcharotone
Smita Patel
Jon A. Jacobson
Hakan Oral
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3643-1

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