title: Increased epicardial fat is independently associated with the presence and chronicity of atrial fibrillation and radiofrequency ablation outcome.
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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Health System, UH B1-132 Taubman/Box 0302, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-0302, USA, jstoanov@umich.edu.
authors.forename: Jadranka
authors.initials: J
authors.lastname: Stojanovska
authors.forename: Ella A
authors.initials: EA
authors.lastname: Kazerooni
authors.forename: Mohamad
authors.initials: M
authors.lastname: Sinno
authors.forename: Barry H
authors.initials: BH
authors.lastname: Gross
authors.forename: Kuanwong
authors.initials: K
authors.lastname: Watcharotone
authors.forename: Smita
authors.initials: S
authors.lastname: Patel
authors.forename: Jon A
authors.initials: JA
authors.lastname: Jacobson
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome