Epicardial Adipose Tissue and Atrial Fibrillation Recurrence

According to lead author Jun Chen, epicardial adipose tissue (EAT), also referred to as epicardial fat tissue (EFT), was associated with an increased risk of atrial fibrillation (AF) recurrence after catheter ablation, based on previously published trial data. Chen and colleagues’ meta-analysis was published in BMC Cardiovascular Disorders, wherein they summarized that EAT should be included into AF recurrence risk assessments prior to a patient undergoing catheter ablation.

Specifically, the full text reported that EAT-related thickness appeared to be the biomarker most heavily associated with increased recurrence risk after an ablation procedure.

The researchers included 10 studies from the PubMed, Embase, and Cochrane Library databases published by November 30, 2021, encompassing a total of 1,840 patients with AF.

Epicardial Adipose Tissue in Patients with Atrial Fibrillation

Reportedly, the investigators’ analyses showed that a higher amount of EAT was associated with a higher risk of AF recurrence after catheter ablation procedure (risk ratio [RR] = 1.06; 95% confidence interval [CI], 1.02-1.11; P=.005), and that EAT-related thickness was strongly associated with higher risk of AF recurrence in patients who were Asian (RR = 1.25; 95% CI, 1.10-1.43; P<.001), aged ≤60 years old (RR = 2.01; 95% CI, 1.18-3.44; P=.010), and had more than one year of follow-up (RR = 1.06; 95% CI, 1.01-1.11, P=.020).

In closing, the authors concluded that “it is necessary to perform an evaluation of EAT for AF individuals before catheter ablation.” Furthermore, they called for future studies to further inform a unified standard of EAT evaluation to be implanted in risk stratification for patients with atrial fibrillation after catheter ablation.

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