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Epicardial adipose tissue density predicts the presence of atrial fibrillation and its recurrence after catheter ablation: three-dimensional reconstructed image analysis

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Abstract

Epicardial adipose tissue (EAT) induces inflammation in the atria and is associated with atrial fibrillation (AF). Several studies have examined the relationship between EAT volume (EAT-V) and density (EAT-D) and the presence of AF after catheter ablation. However, conclusions have been inconsistent. This study included 43 consecutive patients who underwent catheter ablation for AF and 30 control patients. EAT-V and EAT-D around the entire heart, entire atrium, left atrium (LA), and right atrium (RA) were measured in detail using reconstructed three-dimensional (3D) EAT images from dual-source computed tomography (CT). None of the measurements of EAT-V differed significantly between patients with AF and controls or between patients with recurrent AF and those without. On the other hand, all measurements of EAT-D were higher in patients with AF than in controls (entire atrium, p < 0.001; RA, p < 0.001; LA, p = 0.002). All EAT-D measurements were associated with the presence of AF. Among patients with AF who underwent ablation, all EAT-D measurements were higher in patients with recurrent AF than in those without. The difference was significant for EATRA-D (p = 0.032). All atrial EAT-D values predicted recurrent AF (EATRA-D: hazard ratio [HR], 1.208; 95% confidence interval [95% CI], 1.053–1.387; p = 0.007; EATLA-D: HR, 1.108; 95% CI 1.001–1.225; p = 0.047; EATatrial-D: HR, 1.174; 95% CI 1.040–1.325; p = 0.010). The most sensitive cutoffs for predicting recurrent AF were highly accurate for EATRA-D (area under the curve [AUC], 0.76; p < 0.01) and EATatrial-D (AUC = 0.75, p < 0.05), while the cutoff for EATLA-D had low accuracy (AUC, 0.65; p = 0.209). For predicting the presence of AF and recurrent AF after catheter ablation, 3D analysis of atrial EAT-D, rather than EAT-V, is useful.

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Data availability

Data and materials are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan

    Minoru Nodera, Kanae Hasegawa, Shota Kakehashi, Moe Mukai, Daisetsu Aoyama, Shinsuke Miyazaki, Hiroyasu Uzui & Hiroshi Tada

  2. Department of Radiology, University of Fukui Hospital, Fukui, Japan

    Tomokazu Ishida

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  1. Minoru Nodera
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  2. Tomokazu Ishida
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  3. Kanae Hasegawa
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Correspondence to Minoru Nodera.

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Conflict of interest

Hiroshi Tada received honoraria (lecture fees, presentations, or speakers bureaus) from Daiichi- Sankyo Co., Ltd., Biotronik Japan, Inc., Bristol-Myers Squibb, Nippon Boehringer Ingelheim Co., Ltd., Medtronic Japan Co., Ltd., and Novartis Pharma, K.K. Dr. Tada also received research grants from Abbott Medical Japan, LLC, Nippon Boehringer Ingelheim Co., Ltd., Daiichi-Sankyo Co., Ltd., and ALVAUS Inc. (All grants are for research that is unrelated to the subject of the manuscript.) Daisetsu Aoyama belong to endowed department by Biotronik Japan, Inc., DVx Inc., and ALVAUS Co., Ltd. Shota Kakehashi and Moe Mukai belong to endowed department by Medtronic Japan Co., Ltd., DVx Inc., Abbott Medical Japan, LLC, Boston Scientific Japan K.K., and Japan Lifeline Co., Ltd. No other authors have any conflicts of interest to disclose.

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Nodera, M., Ishida, T., Hasegawa, K. et al. Epicardial adipose tissue density predicts the presence of atrial fibrillation and its recurrence after catheter ablation: three-dimensional reconstructed image analysis. Heart Vessels (2024). https://doi.org/10.1007/s00380-024-02384-8

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