Segmental evaluation of predictive value of left atrial epicardial adipose tissue following catheter ablation for atrial fibrillation

Left atrial epicardial adipose tissue (LA-EAT) is associated with the recurrence of atrial tachyarrhythmias (AF/AT) after catheter ablation for atrial fibrillation (AF). However, no previous studies have assessed the predictive value of segment-specific LA-EAT volumes for AF/AT recurrence. This stud...

Full description

Saved in:
Bibliographic Details
Published in:International journal of cardiology 2024-12, Vol.417, p.132558, Article 132558
Main Authors: Tachibana, Shinichi, Inaba, Osamu, Inamura, Yukihiro, Takagi, Takamitsu, Meguro, Shin, Nakata, Kentaro, Michishita, Toshiki, Isonaga, Yuhei, Ohya, Hiroaki, Satoh, Akira, Matsumura, Yutaka, Miyazaki, Shinsuke, Sasano, Tetsuo
Format: Article
Language:English
Subjects:
Atrial fibrillation
Atrial tachyarrhythmia recurrence
Catheter ablation
Epicardial adipose tissue
Multidetector row computed tomography
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Left atrial epicardial adipose tissue (LA-EAT) is associated with the recurrence of atrial tachyarrhythmias (AF/AT) after catheter ablation for atrial fibrillation (AF). However, no previous studies have assessed the predictive value of segment-specific LA-EAT volumes for AF/AT recurrence. This study aimed to assess the relationship between segmental LA-EAT volume and AF/AT recurrence. This study included 350 consecutive patients who underwent initial AF ablation (53.7 % paroxysmal AF (PAF)). Preoperative multidetector row computed tomography assessed LA-EAT, categorized into three segments: anterior-EAT, posterior-EAT, and interatrial septal adipose tissue (IAS-AT). During a mean follow-up period of 351 ± 109 days, 56 patients (16.0 %) experienced AF/AT recurrence. The mean LA-EAT volume was 20.7 ± 11.1 ml and LA-EAT ≥26.8 ml was an independent risk factor for AF/AT recurrence (HR 2.21, 95 % confidence interval (CI): 1.24–3.93, P = 0.007). Receiver operating characteristic analyses revealed the area under the curve for IAS-AT was 0.669 (95 % CI: 0.596–0.743) with an optimal cut-off point of 1.3 ml (sensitivity 76.8 %; specificity 50.0 %), significantly outperforming the anterior- and posterior-EAT in predicting recurrent AF/AT. Multivariate analysis indicated IAS-AT was an independent predictor of AF/AT recurrence in patients with persistent AF (PeAF) (HR 3.52, 95 % CI: 1.52–8.13, P = 0.003), but not in patients with PAF. LA-EAT predicts AF/AT recurrence after AF ablation, with IAS-AT proving significantly more effective than other LA-EAT segments in predicting recurrence. Notably, IAS-AT emerged as an independent predictor of AF/AT recurrence in patients with PeAF but not in those with PAF. [Display omitted] •LA-EAT is associated with the recurrence of AF/AT after catheter ablation for AF.•This is the first study evaluating the predictive value of segment-specific LA-EAT volumes for AF/AT recurrence.•IAS-AT was significantly more effective than other LA-EAT segments in predicting recurrent AF/AT.•IAS-AT emerged as an independent predictor of AF/AT recurrence in patients with PeAF but not in those with PAF.
ISSN:0167-5273
1874-1754
1874-1754
DOI:10.1016/j.ijcard.2024.132558