Abstract
Background Epicardial adipose tissue (EAdT) is metabolically active and likely contributes to atrial fibrillation (AF) through the release of inflammatory cytokines into the myocardium or through its rich innervation with ganglionated plexi at the pulmonary vein ostia. The electrophysiologic mechanisms underlying the association between EAdT and AF remain unclear. Objective The purpose of this study was to investigate the association of EAdT with adjacent myocardial substrate. Methods Thirty consecutive patients who underwent cardiac computed tomography as well as electroanatomic mapping in sinus rhythm before an initial AF ablation procedure were studied. Semiautomatic segmentation of atrial EAdT was performed and registered anatomically to the voltage map. Results In multivariable regression analysis clustered by patient, age (–0.01 per year) and EAdT (–0.29) were associated with log bipolar voltage as well as low-voltage zones (<0.5 mV). Age (odds ratio [OR]: 1.02 per year), male gender (OR: 3.50), diabetes (OR: 2.91), hypertension (OR: 2.55), and EAdT (OR: 8.56) were associated with fractionated electrograms, and age (OR: 2.80), male gender (OR: 3.00), and EAdT (OR: 7.03) were associated with widened signals. Age (OR: 1.03 per year) and body mass index (OR: 1.06 per kg/m2) were associated with atrial fat. Conclusion The presence of overlaying EAdT was associated with lower bipolar voltage and electrogram fractionation as electrophysiologic substrates for AF. EAdT was not a statistical mediator of the association between clinical variables and AF substrate. Body mass index was directly associated with the presence of EAdT in patients with AF.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2333-2339 |
| Number of pages | 7 |
| Journal | Heart Rhythm |
| Volume | 13 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 1 2016 |
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Keywords
- Arrhythmias
- Atrial fibrillation
- Bipolar voltage
- Computerized tomography
- Epicardial adipose tissue
- Fibrosis
- Signal fractionation
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
Association of left atrial epicardial adipose tissue with electrogram bipolar voltage and fractionation : Electrophysiologic substrates for atrial fibrillation. / Zghaib, Tarek; Ipek, Esra Gucuk; Zahid, Sohail; Balouch, Muhammad Adnan; Misra, Satish; Ashikaga, Hiroshi; Berger, Ronald D; Marine, Joseph; Spragg, David D; Zimmerman, Stefan; Zipunnikov, Vadim; Trayanova, Natalia; Calkins, Hugh; Nazarian, Saman.
In: Heart Rhythm, Vol. 13, No. 12, 01.12.2016, p. 2333-2339.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association of left atrial epicardial adipose tissue with electrogram bipolar voltage and fractionation
T2 - Electrophysiologic substrates for atrial fibrillation
AU - Zghaib, Tarek
AU - Ipek, Esra Gucuk
AU - Zahid, Sohail
AU - Balouch, Muhammad Adnan
AU - Misra, Satish
AU - Ashikaga, Hiroshi
AU - Berger, Ronald D
AU - Marine, Joseph
AU - Spragg, David D
AU - Zimmerman, Stefan
AU - Zipunnikov, Vadim
AU - Trayanova, Natalia
AU - Calkins, Hugh
AU - Nazarian, Saman
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background Epicardial adipose tissue (EAdT) is metabolically active and likely contributes to atrial fibrillation (AF) through the release of inflammatory cytokines into the myocardium or through its rich innervation with ganglionated plexi at the pulmonary vein ostia. The electrophysiologic mechanisms underlying the association between EAdT and AF remain unclear. Objective The purpose of this study was to investigate the association of EAdT with adjacent myocardial substrate. Methods Thirty consecutive patients who underwent cardiac computed tomography as well as electroanatomic mapping in sinus rhythm before an initial AF ablation procedure were studied. Semiautomatic segmentation of atrial EAdT was performed and registered anatomically to the voltage map. Results In multivariable regression analysis clustered by patient, age (–0.01 per year) and EAdT (–0.29) were associated with log bipolar voltage as well as low-voltage zones (<0.5 mV). Age (odds ratio [OR]: 1.02 per year), male gender (OR: 3.50), diabetes (OR: 2.91), hypertension (OR: 2.55), and EAdT (OR: 8.56) were associated with fractionated electrograms, and age (OR: 2.80), male gender (OR: 3.00), and EAdT (OR: 7.03) were associated with widened signals. Age (OR: 1.03 per year) and body mass index (OR: 1.06 per kg/m2) were associated with atrial fat. Conclusion The presence of overlaying EAdT was associated with lower bipolar voltage and electrogram fractionation as electrophysiologic substrates for AF. EAdT was not a statistical mediator of the association between clinical variables and AF substrate. Body mass index was directly associated with the presence of EAdT in patients with AF.
AB - Background Epicardial adipose tissue (EAdT) is metabolically active and likely contributes to atrial fibrillation (AF) through the release of inflammatory cytokines into the myocardium or through its rich innervation with ganglionated plexi at the pulmonary vein ostia. The electrophysiologic mechanisms underlying the association between EAdT and AF remain unclear. Objective The purpose of this study was to investigate the association of EAdT with adjacent myocardial substrate. Methods Thirty consecutive patients who underwent cardiac computed tomography as well as electroanatomic mapping in sinus rhythm before an initial AF ablation procedure were studied. Semiautomatic segmentation of atrial EAdT was performed and registered anatomically to the voltage map. Results In multivariable regression analysis clustered by patient, age (–0.01 per year) and EAdT (–0.29) were associated with log bipolar voltage as well as low-voltage zones (<0.5 mV). Age (odds ratio [OR]: 1.02 per year), male gender (OR: 3.50), diabetes (OR: 2.91), hypertension (OR: 2.55), and EAdT (OR: 8.56) were associated with fractionated electrograms, and age (OR: 2.80), male gender (OR: 3.00), and EAdT (OR: 7.03) were associated with widened signals. Age (OR: 1.03 per year) and body mass index (OR: 1.06 per kg/m2) were associated with atrial fat. Conclusion The presence of overlaying EAdT was associated with lower bipolar voltage and electrogram fractionation as electrophysiologic substrates for AF. EAdT was not a statistical mediator of the association between clinical variables and AF substrate. Body mass index was directly associated with the presence of EAdT in patients with AF.
KW - Arrhythmias
KW - Atrial fibrillation
KW - Bipolar voltage
KW - Computerized tomography
KW - Epicardial adipose tissue
KW - Fibrosis
KW - Signal fractionation
UR - http://www.scopus.com/inward/record.url?scp=85016425356&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016425356&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2016.08.030
DO - 10.1016/j.hrthm.2016.08.030
M3 - Article
VL - 13
SP - 2333
EP - 2339
JO - Heart Rhythm
JF - Heart Rhythm
SN - 1547-5271
IS - 12
ER -