Abundant epicardial adipose tissue surrounding the left atrium predicts early rather than late recurrence of atrial fibrillation after catheter ablation

Masuda, Masaharu; Mizuno, Hiroya; Enchi, Yukihiro; Minamiguchi, Hitoshi; Konishi, Shozo; Ohtani, Tomohito; Yamaguchi, Osamu; Okuyama, Yuji; Nanto, Shinsuke; Sakata, Yasushi

doi:10.1007/s10840-015-0031-3

Cited by 45 publications

(19 citation statements)

References 14 publications

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“…Most of the articles (7/10) were in the full-text format, while three articles were in the conference abstract [17,19,20]. CT [[15], [16], [17],[19], [20], [21], [22], [23]] and echocardiography [18,24] were the used imaging modalities for EFT measurements. The least sample size was 38 [17], and the largest ones were related to Chao et al, [18] with 283 patients.…”

Section: Resultsmentioning

confidence: 99%

“…The abundance of EFT and post-ablation AF recurrence was firstly described by Tsao et al; while more than ten different studies have investigated this association up to now [15]. However, these studies have been conducted in different populations, various disease stages (paroxysmal or persistent AF), a variety of EFT measurement methods (computed tomography (CT) or echocardiography), numerous methods of rhythm control strategy (CA or CBA), and diverse intervals of follow-up for AF recurrence [[16], [17], [18], [19], [20], [21], [22], [23], [24]]. The present study was the first attempt to verify the association between AF recurrence and EFT, conducting a meta-analysis of investigations comparing patients with and without AF recurrence after ablation.…”

Section: Introductionmentioning

confidence: 99%

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Is epicardial fat tissue associated with atrial fibrillation recurrence after ablation? A systematic review and meta-analysis

Shamloo

Dagres

Dinov

et al. 2019

IJC Heart & Vasculature

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IntroductionAlthough an undoubted association between epicardial fat tissue (EFT) and atrial fibrillation (AF) has been recently approved, the association between EFT and post-ablation AF recurrence is not evident yet. This study aimed to assess the association between EFT and AF recurrence after ablation.MethodsThe present study was a systematic review and meta-analysis using related literature available in electronic databases until July 2018 via “atrial fibrillation” and “epicardial fat” as the main keywords. Considering the different methods of EFT measurement, three different pooled meta-analyses were conducted in this study including: 1) comparison of total EFT volume, 2) left atrium (LA)-EFT volume, and 3) EFT thickness between two groups with and without AF recurrence estimating standardized mean difference (SMD) through a random and non-random effect meta-analysis. Statistical analysis was also performed using Comprehensive Meta-analysis (CMA) Software.ResultsFollowing a search into a total number of 518 articles, the findings of 12 studies published in 10 articles were enrolled in this meta-analysis. Accordingly, the results of meta-analysis showed that LA-EFT and total EFT volumes were higher in recurrent subjects (LA-EFT: SMD = 0.862 ml; I2 = 0.00, 95% confidence interval (CI) = 0.567–1.156; total EFT: SMD = 1.017 ml, I2 = 0.00, 95% CI = 0.748–1.286). Besides, a significant higher EFT thickness in patients with AF recurrence compared to those with no AF recurrence was observed (SMD = 0.808 mm, I2 = 91.07, 95% CI = 0.215–1401).ConclusionThe total EFT and LA-EFT volumes, as well as EFT thickness, seemed to be associated with AF recurrence in patients undergoing AF ablation.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is epicardial fat tissue associated with atrial fibrillation recurrence after ablation? A systematic review and meta-analysis

Shamloo

Dagres

Dinov

et al. 2019

IJC Heart & Vasculature

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“…Whether EAT has a physiological role to protect these ganglia against mechanical forces due to cardiac contraction has been suggested (266). By contrast, recent clinical data showed that periatrial EAT is an independent predictor of AF recurrence after ablation (157,202,219,296), supporting that EAT may have a pro-arrhythmic influence.…”

Section: Therefore Overlap Between Eat Locations and High Dominant Fmentioning

confidence: 99%

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

Gaborit

Sengenès

Ancel

et al. 2017

Comprehensive Physiology

120

109

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Epicardial adipose tissue (EAT) is a small but very biologically active ectopic fat depot that surrounds the heart. Given its rapid metabolism, thermogenic capacity, unique transcriptome, secretory profile, and simply measurability, epicardial fat has drawn increasing attention among researchers attempting to elucidate its putative role in health and cardiovascular diseases. The cellular crosstalk between epicardial adipocytes and cells of the vascular wall or myocytes is high and suggests a local role for this tissue. The balance between protective and proinflammatory/profibrotic cytokines, chemokines, and adipokines released by EAT seem to be a key element in atherogenesis and could represent a future therapeutic target. EAT amount has been found to predict clinical coronary outcomes. EAT can also modulate cardiac structure and function. Its amount has been associated with atrial fibrillation, coronary artery disease, and sleep apnea syndrome. Conversely, a beiging fat profile of EAT has been identified. In this review, we describe the current state of knowledge regarding the anatomy, physiology and pathophysiological role of EAT, and the factors more globally leading to ectopic fat development. We will also highlight the most recent findings on the origin of this ectopic tissue, and its association with cardiac diseases. © 2017 American Physiological Society. Compr Physiol 7:1051-1082, 2017.

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“…Das, et al examined the association between timing of ERAA with the likelihood of PV reconnection at repeat electrophysiology Predictors of ERAA Several predictors of the development of ERAA after AF ablation have been identified and many of these are also predictors of longterm ablation failure. Baseline characteristics such as older age, male gender, presence of structural heart disease, longer AF duration, nonparoxysmal AF type, higher CHA₂DS₂-VASc scores, larger LA size, presence of LV systolic and diastolic dysfunction, and LA epicardial adipose tissue are some of the variables that have been found to predict ERAA and all these are also associated with late arrhythmia recurrence [5]- [12] . Acute procedural findings including incomplete PVI, presence of multiple AF foci, AF inducibility and lack of AF termination during ablation are also associated with ERAA [6], [13], [14] .…”

Section: Original Researchmentioning

confidence: 99%

Early Recurrences During The Blanking Period After Atrial Fibrillation Ablation

Liang

2018

Journal of Atrial Fibrillation

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Early recurrences of atrial arrhythmias (ERAA) after ablation are common and predict late recurrences and ablation failure.However,becausea proportion of patients with ERAA will have no subsequent arrhythmias after the blanking period, consensus guidelines recommend against immediate repeat ablation for ERAA episodes occurring during the first 3 months post-ablation. In this review, we summarize the predictors, significance, and treatment of ERAA after AF ablation.

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Abundant epicardial adipose tissue surrounding the left atrium predicts early rather than late recurrence of atrial fibrillation after catheter ablation

Abstract: The abundance of left atrial EAT independently predicted early recurrence after AF ablation; on the contrary, it did not have an impact on late recurrence. Left atrial EAT may have a pro-arrhythmic influence, especially in the early post-ablation phase.

Cited by 45 publications

References 14 publications

Is epicardial fat tissue associated with atrial fibrillation recurrence after ablation? A systematic review and meta-analysis

Is epicardial fat tissue associated with atrial fibrillation recurrence after ablation? A systematic review and meta-analysis

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

Early Recurrences During The Blanking Period After Atrial Fibrillation Ablation

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