2011 Volume 75 Issue 11 Pages 2559-2565
Background: Whether epicardial adipose tissue (EAT) is independently associated with atrial fibrillation (AF) and outcome after catheter ablation (CA) for AF remains unclear. Methods and Results: Three-dimensional volume-rendering reconstructed images of EAT (total EAT) and EAT surrounding the left atrium (LA-EAT) were measured on 320-row multidetector computed tomography in 40 patients with AF (paroxysmal AF [PAF], n=24; persistent AF [PerAF], n=16) who underwent CA, and in 37 age-matched control patients. EAT volumes were as follows for the control, PAF and PerAF patients: total EAT, 138.3±45.2cm3 vs. 158.3±47.2cm3 vs. 226.4±93.3cm3 (P<0.01 for control or PAF vs. PerAF); LA-EAT, 32.9±14.5cm3 vs. 41.3±15.3cm3 vs. 66.8±35.1cm3 (P<0.001 for control or PAF vs. PerAF). EAT volume was independently associated with the presence of AF after adjustment for possible confounding factors. EAT volume was significantly greater in patients with lone AF than in control patients (total EAT, 132.8±33.3cm3 vs. 106.2±27.3cm3, P=0.021; LA-EAT: 34.0±10.6cm3 vs. 21.8±6.9cm3, P=0.0006). EAT volumes were greater in the 15 AF patients (37.5%) with post-ablation recurrence than in patients without recurrence (total EAT: 239.0±90.2cm3 vs. 153.5±42.7cm3, P=0.0002; LA-EAT: 69.6±35.5cm3 vs. 40.7±13.9cm3, P=0.0008). Conclusions: EAT volume increases in AF patients independent of conventional risk factors and is greater in patients with lone AF than in non-AF patients. EAT volume might be useful for predicting AF recurrence after CA. (Circ J 2011; 75: 2559-2565)
