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Predictive Value of Epicardial Adipose Tissue Parameters Measured by Cardiac Computed Tomography for Recurrence of Atrial Fibrillation After Pulmonary Vein Isolation

Title: Predictive Value of Epicardial Adipose Tissue Parameters Measured by Cardiac Computed Tomography for Recurrence of Atrial Fibrillation After Pulmonary Vein Isolation
Authors: Karol Momot; Michal Pruc; Dariusz Rodkiewicz; Edward Koźluk; Kamil Krauz; Agnieszka Piątkowska; Zuzanna Zalewska; Małgorzata Buksińska-Lisik; Lukasz Szarpak; Artur Mamcarz
Source: Journal of Clinical Medicine ; Volume 14 ; Issue 19 ; Pages: 6963
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2025
Collection: MDPI Open Access Publishing
Subject Terms: catheter ablation; atrial fibrillation; epicardial adipose tissue; computed tomography
Description: Background: Despite advances in ablation strategies, a substantial proportion of patients with atrial fibrillation (AF) experience arrhythmia recurrence, highlighting the need for improved preprocedural risk stratification. One of the emerging factors associated with arrhythmogenic remodeling is epicardial adipose tissue (EAT), particularly in the proximity of the left atrium (LA), due to its metabolic and inflammatory activity. Methods: This study investigated whether preprocedural assessment of EAT parameters on computed tomography (CT), including volume, mean attenuation, and attenuation dispersion, could predict AF recurrence following ablation. Seventy patients with AF underwent either pulsed field or cryoballoon ablation and were followed for 18 months. Results: Recurrence of AF occurred in 26 (37.1%) patients. Both higher LA-EAT attenuation (OR 1.09; 95% CI: 1.02–1.17) and greater total-EAT volume (OR 2.41; 95% CI: 1.16–4.99) were independently associated with arrhythmia recurrence. Subgroup analysis revealed that LA-EAT volume was highly predictive of recurrence in patients with persistent AF (AUC = 0.91), whereas LA-EAT attenuation demonstrated greater prognostic value in those with paroxysmal AF (AUC = 0.80). Conclusions: These findings suggest that quantitative evaluation of EAT using routine cardiac CT may enhance risk stratification before ablation.
Document Type: text
File Description: application/pdf
Language: English
Relation: Cardiology; https://dx.doi.org/10.3390/jcm14196963
DOI: 10.3390/jcm14196963
Availability: https://doi.org/10.3390/jcm14196963
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.F068396B
Database: BASE