Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Epicardial Atrial Fat at Cardiac Magnetic Resonance Imaging and AF Recurrence after Transcatheter Ablation

Andrea Ballatore
,
Marco Gatti
,
Serena Mella
,
Davide Tore
ORCID logo ,
Henri Xhakupi
ORCID logo ,
Fabio Giorgino
,
Andrea Saglietto
ORCID logo ,
Ludovica Carmagnola
,
Edoardo Roagna
,
Gaetano Maria De Ferrari
,
Riccardo Faletti
,
Matteo Anselmino
* ORCID logo
Version 1 : Received: 18 December 2023 / Approved: 19 December 2023 / Online: 19 December 2023 (16:00:44 CET)

How to cite: Ballatore, A.; Gatti, M.; Mella, S.; Tore, D.; Xhakupi, H.; Giorgino, F.; Saglietto, A.; Carmagnola, L.; Roagna, E.; De Ferrari, G.M.; Faletti, R.; Anselmino, M. Epicardial Atrial Fat at Cardiac Magnetic Resonance Imaging and AF Recurrence after Transcatheter Ablation. Preprints 2023, 2023121440. https://doi.org/10.20944/preprints202312.1440.v1 Ballatore, A.; Gatti, M.; Mella, S.; Tore, D.; Xhakupi, H.; Giorgino, F.; Saglietto, A.; Carmagnola, L.; Roagna, E.; De Ferrari, G.M.; Faletti, R.; Anselmino, M. Epicardial Atrial Fat at Cardiac Magnetic Resonance Imaging and AF Recurrence after Transcatheter Ablation. Preprints 2023, 2023121440. https://doi.org/10.20944/preprints202312.1440.v1

Abstract

The relationship between epicardial adipose tissue (EAT) and atrial fibrillation (AF) has gained interest in recent years. Previous literature on the topic presents great heterogeneity, focusing especially on computed tomog-raphy imaging. Aim of the present study is to determine whether an increased volume of left atrial (LA) EAT evaluated at routine pre-procedural cardiac magnetic resonance imaging (MRI) relates to AF recurrences after catheter ablation. 50 patients undergoing AF cryoballoon ablation and pre-procedural cardiac MRI allowing quantification of LA EAT were enrolled. In one patient segmentation of LA EAT could not be achieved. After a median follow-up of 16.0 months, AF recurrences occurred in 17 patients (34%). Absolute volume of EAT was not different in patients with and without AF recurrences (10.35 ml vs. 10.29 ml; p-value=0.963), whereas volume of EAT indexed on the LA (EATi) was lower, albeit non statistically significant, in patients free from arrhythmias (12.77% vs. 14.06%; p-value=0.467). Receiver operating characteristic curve testing the ability of EATi to predict AF recurrence after catheter ablation showed sub-optimal performance (AUC: 0.588). The finest identified cut-off of EATi was 10.65%, achieving a sensitivity of 0.5, a specificity of 0.82, a positive predictive value of 0.59 and a negative predictive value of 0.76. Patients with values of EATi lower than 10.65% showed greater survival free from arrhythmias than patients with values above this cut-off (84% vs. 48%; p-value=0.04). In conclusion, indexed LA EAT volume evaluated at cardiac MRI independently relates to arrhythmia recurrence after AF cryoballoon ablation.

Keywords

atrial fibrillation; catheter ablation; epicardial adipose tissue; magnetic resonance; cryoballoon ablation.

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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