Epicardial adipose tissue dispersion at CT and recurrent atrial fibrillation after pulmonary vein isolation

Figures

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  Fig. 1. Epicardial adipose tissue (EAT) dispersion calculation on a contrast-enhanced CT scan around the left atrium (LA). A The LA EAT within the pericardium was segmented between the coronary sinus, the superior margin of the left atrial appendage, the mitral valve, and the interatrial septum (red line). B Voxels within the included volume (blue color) were analyzed and separated in a low (voxels in green between − 195 and − 45 HU) and high (voxels in red between − 45 and − 15 HU) threshold LA EAT compartment (C)

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  Fig. 2. Examples of two patients with left atrial (LA) epicardial adipose tissue (EAT) dispersion calculation. Patient A with no AF recurrence had a small LA EAT dispersion, defined as the difference between the mean attenuation of the low (green) and high (red) threshold EAT compartment. Patient B with AF recurrence had a high LA EAT dispersion

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  Fig. 3. Kaplan–Meier curves showing AF recurrence in patients with (A) LA EAT dispersion, (B) AF phenotype, and (C) a combination of AF phenotype with LA EAT dispersion. AF recurrence was significantly more frequent in patients with LA EAT dispersion > 50.8 HU (red curve in A) and in patients with persistent AF (red curve in B). Patients with LA EAT dispersion < 50.8 and paroxysmal AF had the lowest AF recurrence rate of 22% (blue curve in C), while patients with LA EAT dispersion > 50.8 and persistent AF had the highest AF recurrence rate of 71% (p < 0.001, orange curve in C). AF, atrial fibrillation; LA, left atrial; EAT, epicardial adipose tissue