Arrhythmias & electrophysiology
Changes in epicardial adipose tissue volume before and after cryoballoon ablation in patients with atrial fibrillation: Supporting the “AF begets epicardial adipose tissue (EAT)” theory
Authors' conclusion
These findings suggest a novel "AF begets EAT" theory, complementing the previously accepted role of EAT as a cause of AF and supporting the "AF begets AF" mechanism.
Study context
- Population
- Patients undergoing cryoballoon ablation for AF
- Participants
- 247 patients
- Exposure
- Persistent AF vs paroxysmal AF
- Persistent AFn = 33
- Paroxysmal AFn = 214reference
- Outcome
- Change in EAT volume (Total-EATV and LA-EATV) by contrast-enhanced CT
- Follow-up
- 6 months after cryoballoon ablation
Main finding
As reported in the abstract
EAT volume, baseline to 6 months · 6 months
| Group | Total-EATV | LA-EATV |
|---|---|---|
| Persistent AF | 148.8 ± 53.3 mL to 142.9 ± 53.5 mL (P = .01) | 26.8 ± 11.3 mL to 25.2 ± 10.7 mL (P = .01) |
Persistent AF
Total-EATV148.8 ± 53.3 mL to 142.9 ± 53.5 mL (P = .01)
LA-EATV26.8 ± 11.3 mL to 25.2 ± 10.7 mL (P = .01)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Association with LARR | 2.34 (1.01–5.44) | P = 0.05 | |
| 0.20.5125Odds ratio (log scale) |
Left atrial reverse remodeling (LARR) and EAT volume (EATV) reduction
- LARR independently correlated with Total-EATV reduction (OR)
- 1.78 (P = .04)
- LARR independently correlated with LA-EATV reduction (OR)
- 2.80 (P < .001)
Sinus rhythm at 6 months
- All patients but one with persistent AF in sinus rhythm
Original publication
Changes in epicardial adipose tissue volume before and after cryoballoon ablation in patients with atrial fibrillation: Supporting the “AF begets EAT” theory. Heart Rhythm. Published 28 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it