Arrhythmias & electrophysiologyCohort study
Periatrial Epicardial Adipose Tissue as a Predictor of Substrate Distribution and Atrial Arrhythmia Recurrence in Patients with Early Atrial Remodeling
- Consecutive patients underwent high-resolution left atrial (LA) electroanatomic mapping before index atrial fibrillation ablation
- healthy control cohort for voltage cutpoints
- multivariable modeling
- 12-month follow-up
Authors' conclusion
EAT plays an early and likely causal role in atrial substrate development, particularly on the posterior wall. Unipolar voltage mapping may provide additional value in identifying early atrial substrate.
Study context
- Population
- Patients with early atrial remodeling undergoing index atrial fibrillation ablation (bipolar low-voltage area <5%)patients included (aged 56 ± 11 years, 78% paroxysmal)
- Participants
- Fifty patients
- Exposure
- Left atrial epicardial adipose tissue (EAT) presence vs local unipolar and bipolar voltage and postablation arrhythmia recurrence
Main finding
As reported in the abstract
Unipolar voltage scar among points with preserved bipolar voltage
additional points identified as scar by unipolar voltage cutpoints
9.2%
Observational data: associations, not effects.
Further findings
Local bipolar voltage predicted by EAT presence
- EAT presence significant predictor of local bipolar voltage
- P = 0.010
Posterior wall voltage predicted by EAT presence
- unipolar voltage
- P = 0.027
- bipolar voltage
- P = 0.007
Atrial arrhythmia recurrence among patients with paroxysmal atrial fibrillation · 12-month follow-up
- posterior:LA EAT ratio the only independent predictor
Original publication
Periatrial Epicardial Adipose Tissue as a Predictor of Substrate Distribution and Atrial Arrhythmia Recurrence in Patients with Early Atrial Remodeling. Heart Rhythm. Published 17 September 2026. doi:10.1016/j.hrthm.2026.09.017
Summarised from the published abstract; every number is checked against it