Association Between Epicardial Adipose Tissue Volumes on 3-Dimensional Reconstructed CT Images and Recurrence of Atrial Fibrillation After Catheter Ablation

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 ± 45.2 cm³ vs. 158.3 ± 47.2 cm³ vs. 226.4 ± 93.3 cm³ (P<0.01 for control or PAF vs. PerAF); LA-EAT, 32.9 ± 14.5 cm³ vs. 41.3 ± 15.3 cm³ vs. 66.8 ± 35.1 cm³ (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 ± 33.3 cm³ vs. 106.2 ± 27.3 cm³, P=0.021; LA-EAT: 34.0 ± 10.6 cm³ vs. 21.8 ± 6.9 cm³, 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 ± 90.2 cm³ vs. 153.5 ± 42.7 cm³, P=0.0002; LA-EAT: 69.6 ± 35.5 cm³ vs. 40.7 ± 13.9 cm³, 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.