BackgroundPrevious studies showed that the quantity of the left atrial (LA) periatrial fat tissue predicts recurrence after catheter ablation of atrial fibrillation (AF). We hypothesized that the quality of the LA periatrial fat tissue, measured by the mean computed tomography attenuation, predicts recurrence after AF ablation independent of the quantity of the LA periatrial fat tissue.MethodsWe included 143 consecutive patients with drug-refractory AF referred for the first catheter ablation of AF (62.2±10 years, 40% nonparoxysmal AF). All participants had a preablation cardiac computed tomography. We measured the quantity of the LA periatrial fat tissue by the area (millimeter square) and the quality by the mean computed tomography attenuation (Hounsfield units) in a standard 4-chamber view.ResultsPatients with AF recurrence after ablation (n=57) had a significantly larger fat area (167.6 [interquartile range, 124.1–255] versus 145.4 [95.6–229.3] mm²; P=0.018) and a higher fat attenuation (−92.0±9.8 versus −96.5±9.4 Hounsfield units; P=0.006) than those without recurrence (controls). LA fat attenuation was correlated with LA fat volume and LA bipolar voltage by invasive mapping and was associated with AF recurrence after adjusting for clinical risk factors, including body mass index, AF type, LA dimension, and fat area (hazard ratio, 2.65; P=0.001).ConclusionsThe quality of the LA periatrial fat tissue is an independent predictor of recurrence after the first AF ablation. Assessment of LA periatrial fat attenuation can improve AF ablation outcomes by refining patient selection.

中文翻译：

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儿科脂肪质量可预测房颤消融的结果。

背景先前的研究表明，左心房（LA）的房颤脂肪组织的数量预示着导管消融房颤（AF）后的复发。我们假设通过平均X线断层摄影术衰减测量的LA周围脂肪组织的质量可以预测房颤消融后的复发，而与LA周围脂肪组织的数量无关。导管消融房颤（62.2±10年，非阵发性房颤40％）。所有参与者均进行了消融前心脏计算机断层扫描。在标准的4腔视图中，我们通过面积（毫米平方）测量了LA周围脂肪组织的数量，并通过平均计算机断层摄影衰减（Hounsfield单位）测量了质量。² ; P = 0.018）和比无复发者（对照）更高的脂肪衰减率（-92.0±9.8对-96.5±9.4 Hounsfield单位；P = 0.006）。通过侵入性作图，LA脂肪衰减与LA脂肪量和LA双极电压相关，并在校正了临床风险因素（包括体重指数，AF类型，LA尺寸和脂肪面积（危险比，2.65；P）后，与AF复发相关= 0.001）。结论左房室脂肪组织的质量是首次房颤消融后复发的独立预测指标。通过改善患者选择，评估LA围产期脂肪衰减可改善房颤消融效果。