Pericardial fat and the Risk of Atrial Tachy-arrhythmia Recurrence Post Pulmonary Vein Isolation: A Computed Tomography Study

Background

Obesity is increasingly recognized as a novel risk factor that contributes significantly to the frequency of atrial fibrillation (AF). There has been a growing interest in assessing the impact of local fat deposits and the appearance of AF. Pericardial fat and epicardial fat has been hypothesized to exert local and systemic pathogenic effects nearby cardiac structures.

Objectives: The aim of this study was to assess the association between pericardial fat and atrial tachy-arrhythmia post pulmonary vein isolation (PVI).

Methods Thirteen consecutive patients (Age, Gender) with AF who underwent contrast enhanced computed tomography (CT) before PVI at our center were included. Epicardial, pericardial and periatrial fat volumes of 13 patients were quantified and the association between the local fat (epicardial, pericardial and periatrial fat) and the presence of atrial arrhythmia post PVI was assessed.

Results

As compared with successful AF ablation patients with post ablation AF have a trend towards increased epicardial fat volume (96.7 ± 47 vs. 58.2± 19 ml, retrospectively; P =0.22 ), pericardial fat (165 ± 45 ML vs.84.1 ± 33.1ml;  retrospectively; P = 0.11) and periatriall fat (103 ± 25ml vs. 44.6 ml± 20.4ml; retrospectively; P =0.11) and  total fat (365 ± 74ml vs.187 ± 28 ml retrospectively; P = 0.16 ).

Conclusions

Our ongoing study demonstrated that patients with recurrence of atrial tachycarritmia post PVI have a trend towards increased pericardial and epicardial fat, as assessed by contrast enhanced CT.