High epicardial fat volume is associated with atrial fibrillation recurrences after catheter ablation

Abstract Background Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation therapy for atrial fibrillation (AF). However, even with important technological improvements, AF recurrences are common in long-term follow-up. Recently, epicardial fat tissue (EFT) has been proposed as a potential modulator promoting and sustaining arrhythmogenic milieu. Aim In this retrospective single-centre study, we sought to evaluate association between CT-quantified EFT volume primary PVI outcome assed by means continuous ECG monitoring implantable loop recorders (ILR) paroxysmal patients. Methods A cohort 92 patients (median age 60.2 [IQR 51.9–64.0]; 74% male) (a single persistent episode was accepted) undergoing targeted at analysed. Prior CA all underwent cardiac CT imaging subsequent implantation recorder (ILR). Radiofrequency electro-anatomical mapping used 79 patients, balloon cryoablation 13 Verified complete defined procedural endpoint. semi-automatically segmented quantified on contrast enhanced studies. recurrence, burden >0.1% after blanking period (90 days), continuously assessed ILR. Kaplan-Meier analysis recurrence-free survival 1-year, 2-year 3-year follow-up periods compared stratified into tertiles. Results During median 52.6 months 43–64], recurrence detected 58 (63%) 29 (50%) them repeat ablation. Patients high, mid, low total tertiles had time late 154, 373, 284 days (Fig. 1A). At 1-year follow-up, high tertile worst (p=0.023). difference gradually faded-out became non-significant 2 3 years. ROC revealed an 95 ml optimal cut-off (p=0.002) expected arrhythmia post acutely successful 1B). Conclusion quantification relatively homogenous, monitored significant 1 year fat. These results suggest possible role adipose adverse pro-fibrillatory factor. Identified cut-offs have be validated prospectively larger balanced patient population. Funding Acknowledgement Type funding sources: None.