Epicardial adipose tissue thickness and ablation outcome of atrial fibrillation.
OBJECTIVE
Epicardial fat was closely related to atrial fibrillation (AF). Transthoracic echocardiography (TTE) has been proposed to be a convenient imaging tool in assessing epicardial adipose tissue (EAT). The goal of the present study was to investigate whether the EAT thickness measured on TTE was a useful parameter in predicting procedural outcomes of AF ablations.


RESULTS
A total of 227 paroxysmal AF (PAF) and 56 non-paroxysmal AF (non-PAF) patients receiving catheter ablations from 2008-2010 were enrolled. Echocardiography-derived regional EAT thickness from parasternal long-axis view was quantified for each patient. Free of recurrence was defined as the absence of atrial arrhythmias without using antiarrhythmic agents after ablations. The mean EAT thickness of the study population was 6.1 ± 0.8 mm. Non-PAF patients had a thicker EAT than that of PAF patients (7.0 ± 0.7 mm versus 5.9 ± 0.7 mm, p value <0.001). During the follow-up of 16 ± 9 months, there were 95 patients (33.6%) suffering from recurrences of atrial arrhythmias. Non-PAF, chads2 score, left atrial diameter and EAT thickness were independent predictors of recurrence after catheter ablations. At a cutoff value of 6 mm for PAF and 6.9 mm for non-PAF, the measurement of EAT thickness could help us to identify patients at risk of recurrences.


CONCLUSIONS
EAT thickness may serve as a useful parameter in predicting recurrences after AF ablations. Compared to other imaging modalities, TTE can be an alternative choice with less cost and time in assessing the effects of EAT on ablation outcomes.
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan ; Institute of Clinical Medicine and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.
Tze-Fan
TF
Chao
Chung-Lieh
CL
Hung
Hsuan-Ming
HM
Tsao
Yenn-Jiang
YJ
Lin
Chun-Ho
CH
Yun
Yau-Huei
YH
Lai
Shih-Lin
SL
Chang
Li-Wei
LW
Lo
Yu-Feng
YF
Hu
Ta-Chuan
TC
Tuan
Hung-Yu
HY
Chang
Jen-Yuan
JY
Kuo
Hung-I
HI
Yeh
Tsu-Juey
TJ
Wu
Ming-Hsiung
MH
Hsieh
Wen-Chung
WC
Yu
Shih-Ann
SA
Chen
D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000378:metabolism*