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Pericardial fat associated with AF presence, severity after ablation
Wong C. J Am Coll Cardiol. 2011;57:1745-1751.
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After ablation, pericardial fat volume was found to correlate with the presence and severity of atrial fibrillation, as well as poorer outcomes, and produced stronger associations than more systematic measures of adiposity, according to a new study.
“Our findings are consistent with the hypothesis of a local pathogenic effect of pericardial fat on the arrhythmogenic substrate supporting AF,” the researchers wrote.
The group of Australia-based researchers examined 110 patients undergoing first-time AF ablation and 20 reference patients without AF via cardiac MRI for the quantification of periventricular, periatrial and total pericardial fat volumes. They then followed up with patients at 3, 6, 9, 12, 18 and 24 months, and then on a yearly basis until AF recurrence.
After multivariate adjustment, as well as additional adjustment for body weight, volumes of pericardial fat were strongly linked to the presence of AF (P=.005), AF symptom burden (P=.003) and AF chronicity (P=.015). Additionally, pericardial fat volumes were predictive of AF recurrence, as more extensive volume resulted in an earlier recurrence of AF after the index ablation procedure (P=.035), whereas BMI and body surface area were not predictive.
Analysis of the left atrium also revealed that each one standard deviation increase in periatrial fat, periventricular fat and total pericardial fat led to statistically significant gains in left atrium volume after adjustments (P<.03 for all).
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