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Revista Colombiana de Cardiología

Print version ISSN 0120-5633

Abstract

QUINTERO-YEPES, Viviana et al. Association of epicardial adipose tissue with atrial fibrillation and prognosis following pulmonary vein ablation. Rev. Colomb. Cardiol. [online]. 2017, vol.24, n.3, pp.261-268.  Epub Mar 09, 2017. ISSN 0120-5633.  http://dx.doi.org/10.1016/j.rccar.2016.11.011.

Introduction:

Accumulation of epicardial adipose tissue is associated with obesity and an increase of prevalence, severity and recurrence following ablation of atrial fibrillation. Within the implicated mechanisms, a proinflammatory state is considered when it leads to the structural remodelling of the atrium and to the alteration of the electrophysiological properties of atrial myocytes. So far this phenomenon has not been studied in Colombia.

Motivation:

To prove the association in a group of patients of our population who underwent radiofrequency ablation of pulmonary veins.

Material and methods:

170 coronary CT angiographies were reviewed prior to the pulmonary vein ablation in patients with a history of atrial fibrillation. Patients with incomplete data were excluded from the analysis, 94 were analysed. Epicardial adipose tissue thickness and body mass index were measured, and their relationship with atrial fibrillation subtypes was assessed, as well as relapses following the ablation.

Results:

Most participants were overweight or obese. Both obese and overweight patients had a significantly thicker total epicardial adipose tissue than those with a normal body mass index (p = 0.01). The thickness of epicardial fat was significantly higher in persistent atrial fibrillation in comparison with paroxysmal atrial fibrillation (p = 0.01). Patients with relapses did not show a significant difference but they did have a higher tendency to greater total epicardial adipose tissue. The increase in atrial size was significantly relates to the thickness of epicardial adipose tissue (p = 0.05). Multivariate logistic regression analysis kept this relationship.

Conclusions:

The increase in epicardial adipose tissue is independently related to being overweight and obese, as well as to severity and prognosis of atrial fibrillation. Prospective cohort studies must be conducted where normal cut-off values for our population group are assessed and established, and the long-term progress following pulmonary vein ablation and other procedures such as weight loss surgery is followed.

Keywords : Atrial fibrillation; Epicardial adipose tissue; Epicardial adipose tissue thickness; Catheter ablation.

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