Periatrial Fat Quality Predicts Atrial Fibrillation Ablation Outcome

Luisa Ciuffo, Hieu Nguyen, Mateus Diniz Marques, Konstantinos N. Aronis, Bhradeev Sivasambu, Henrique D. de Vasconcelos, Susumu Tao, David D Spragg, Joseph Marine, Ronald D Berger, Joao Lima, Hugh Calkins, Hiroshi Ashikaga

Research output: Contribution to journalArticle

Abstract

Background Previous studies showed that the quantity of the left atrial (LA) periatrial fat tissue predicts recurrence after catheter ablation of atrial fibrillation (AF). We hypothesized that the quality of the LA periatrial fat tissue, measured by the mean computed tomography attenuation, predicts recurrence after AF ablation independent of the quantity of the LA periatrial fat tissue. Methods We included 143 consecutive patients with drug-refractory AF referred for the first catheter ablation of AF (62.2±10 years, 40% nonparoxysmal AF). All participants had a preablation cardiac computed tomography. We measured the quantity of the LA periatrial fat tissue by the area (millimeter square) and the quality by the mean computed tomography attenuation (Hounsfield units) in a standard 4-chamber view. Results Patients with AF recurrence after ablation (n=57) had a significantly larger fat area (167.6 [interquartile range, 124.1-255] versus 145.4 [95.6-229.3] mm2; P=0.018) and a higher fat attenuation (-92.0±9.8 versus -96.5±9.4 Hounsfield units; P=0.006) than those without recurrence (controls). LA fat attenuation was correlated with LA fat volume and LA bipolar voltage by invasive mapping and was associated with AF recurrence after adjusting for clinical risk factors, including body mass index, AF type, LA dimension, and fat area (hazard ratio, 2.65; P=0.001). Conclusions The quality of the LA periatrial fat tissue is an independent predictor of recurrence after the first AF ablation. Assessment of LA periatrial fat attenuation can improve AF ablation outcomes by refining patient selection.

Original languageEnglish (US)
Pages (from-to)e008764
JournalCirculation. Cardiovascular imaging
Volume12
Issue number6
DOIs
StatePublished - Jun 1 2019

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Atrial Fibrillation
Fats
Recurrence
Catheter Ablation
Tomography
Patient Selection
Body Mass Index

Keywords

  • atrial fibrillation
  • body mass index
  • catheter ablation
  • patient selection
  • risk factors

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Ciuffo, L., Nguyen, H., Marques, M. D., Aronis, K. N., Sivasambu, B., de Vasconcelos, H. D., ... Ashikaga, H. (2019). Periatrial Fat Quality Predicts Atrial Fibrillation Ablation Outcome. Circulation. Cardiovascular imaging, 12(6), e008764. https://doi.org/10.1161/CIRCIMAGING.118.008764

Periatrial Fat Quality Predicts Atrial Fibrillation Ablation Outcome. / Ciuffo, Luisa; Nguyen, Hieu; Marques, Mateus Diniz; Aronis, Konstantinos N.; Sivasambu, Bhradeev; de Vasconcelos, Henrique D.; Tao, Susumu; Spragg, David D; Marine, Joseph; Berger, Ronald D; Lima, Joao; Calkins, Hugh; Ashikaga, Hiroshi.

In: Circulation. Cardiovascular imaging, Vol. 12, No. 6, 01.06.2019, p. e008764.

Research output: Contribution to journalArticle

Ciuffo L, Nguyen H, Marques MD, Aronis KN, Sivasambu B, de Vasconcelos HD et al. Periatrial Fat Quality Predicts Atrial Fibrillation Ablation Outcome. Circulation. Cardiovascular imaging. 2019 Jun 1;12(6):e008764. https://doi.org/10.1161/CIRCIMAGING.118.008764
Ciuffo, Luisa ; Nguyen, Hieu ; Marques, Mateus Diniz ; Aronis, Konstantinos N. ; Sivasambu, Bhradeev ; de Vasconcelos, Henrique D. ; Tao, Susumu ; Spragg, David D ; Marine, Joseph ; Berger, Ronald D ; Lima, Joao ; Calkins, Hugh ; Ashikaga, Hiroshi. / Periatrial Fat Quality Predicts Atrial Fibrillation Ablation Outcome. In: Circulation. Cardiovascular imaging. 2019 ; Vol. 12, No. 6. pp. e008764.
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abstract = "Background Previous studies showed that the quantity of the left atrial (LA) periatrial fat tissue predicts recurrence after catheter ablation of atrial fibrillation (AF). We hypothesized that the quality of the LA periatrial fat tissue, measured by the mean computed tomography attenuation, predicts recurrence after AF ablation independent of the quantity of the LA periatrial fat tissue. Methods We included 143 consecutive patients with drug-refractory AF referred for the first catheter ablation of AF (62.2±10 years, 40{\%} nonparoxysmal AF). All participants had a preablation cardiac computed tomography. We measured the quantity of the LA periatrial fat tissue by the area (millimeter square) and the quality by the mean computed tomography attenuation (Hounsfield units) in a standard 4-chamber view. Results Patients with AF recurrence after ablation (n=57) had a significantly larger fat area (167.6 [interquartile range, 124.1-255] versus 145.4 [95.6-229.3] mm2; P=0.018) and a higher fat attenuation (-92.0±9.8 versus -96.5±9.4 Hounsfield units; P=0.006) than those without recurrence (controls). LA fat attenuation was correlated with LA fat volume and LA bipolar voltage by invasive mapping and was associated with AF recurrence after adjusting for clinical risk factors, including body mass index, AF type, LA dimension, and fat area (hazard ratio, 2.65; P=0.001). Conclusions The quality of the LA periatrial fat tissue is an independent predictor of recurrence after the first AF ablation. Assessment of LA periatrial fat attenuation can improve AF ablation outcomes by refining patient selection.",
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AU - Ciuffo, Luisa

AU - Nguyen, Hieu

AU - Marques, Mateus Diniz

AU - Aronis, Konstantinos N.

AU - Sivasambu, Bhradeev

AU - de Vasconcelos, Henrique D.

AU - Tao, Susumu

AU - Spragg, David D

AU - Marine, Joseph

AU - Berger, Ronald D

AU - Lima, Joao

AU - Calkins, Hugh

AU - Ashikaga, Hiroshi

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N2 - Background Previous studies showed that the quantity of the left atrial (LA) periatrial fat tissue predicts recurrence after catheter ablation of atrial fibrillation (AF). We hypothesized that the quality of the LA periatrial fat tissue, measured by the mean computed tomography attenuation, predicts recurrence after AF ablation independent of the quantity of the LA periatrial fat tissue. Methods We included 143 consecutive patients with drug-refractory AF referred for the first catheter ablation of AF (62.2±10 years, 40% nonparoxysmal AF). All participants had a preablation cardiac computed tomography. We measured the quantity of the LA periatrial fat tissue by the area (millimeter square) and the quality by the mean computed tomography attenuation (Hounsfield units) in a standard 4-chamber view. Results Patients with AF recurrence after ablation (n=57) had a significantly larger fat area (167.6 [interquartile range, 124.1-255] versus 145.4 [95.6-229.3] mm2; P=0.018) and a higher fat attenuation (-92.0±9.8 versus -96.5±9.4 Hounsfield units; P=0.006) than those without recurrence (controls). LA fat attenuation was correlated with LA fat volume and LA bipolar voltage by invasive mapping and was associated with AF recurrence after adjusting for clinical risk factors, including body mass index, AF type, LA dimension, and fat area (hazard ratio, 2.65; P=0.001). Conclusions The quality of the LA periatrial fat tissue is an independent predictor of recurrence after the first AF ablation. Assessment of LA periatrial fat attenuation can improve AF ablation outcomes by refining patient selection.

AB - Background Previous studies showed that the quantity of the left atrial (LA) periatrial fat tissue predicts recurrence after catheter ablation of atrial fibrillation (AF). We hypothesized that the quality of the LA periatrial fat tissue, measured by the mean computed tomography attenuation, predicts recurrence after AF ablation independent of the quantity of the LA periatrial fat tissue. Methods We included 143 consecutive patients with drug-refractory AF referred for the first catheter ablation of AF (62.2±10 years, 40% nonparoxysmal AF). All participants had a preablation cardiac computed tomography. We measured the quantity of the LA periatrial fat tissue by the area (millimeter square) and the quality by the mean computed tomography attenuation (Hounsfield units) in a standard 4-chamber view. Results Patients with AF recurrence after ablation (n=57) had a significantly larger fat area (167.6 [interquartile range, 124.1-255] versus 145.4 [95.6-229.3] mm2; P=0.018) and a higher fat attenuation (-92.0±9.8 versus -96.5±9.4 Hounsfield units; P=0.006) than those without recurrence (controls). LA fat attenuation was correlated with LA fat volume and LA bipolar voltage by invasive mapping and was associated with AF recurrence after adjusting for clinical risk factors, including body mass index, AF type, LA dimension, and fat area (hazard ratio, 2.65; P=0.001). Conclusions The quality of the LA periatrial fat tissue is an independent predictor of recurrence after the first AF ablation. Assessment of LA periatrial fat attenuation can improve AF ablation outcomes by refining patient selection.

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