Document Detail

Pericardial fat is associated with atrial fibrillation severity and ablation outcome.
MedLine Citation:
PMID:  21511110     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of this study was to characterize the relationship between pericardial fat and atrial fibrillation (AF).
BACKGROUND: Obesity is an important risk factor for AF. Pericardial fat has been hypothesized to exert local pathogenic effects on nearby cardiac structures above and beyond that of systemic adiposity.
METHODS: One hundred ten patients undergoing first-time AF ablation and 20 reference patients without AF underwent cardiac magnetic resonance imaging for the quantification of periatrial, periventricular, and total pericardial fat volumes using a previously validated technique. Together with body mass index and body surface area, these were examined in relation to the presence of AF, the severity of AF, left atrial volume, and long-term AF recurrence after ablation.
RESULTS: Pericardial fat volumes were significantly associated with the presence of AF, AF chronicity, and AF symptom burden (all p values <0.05). Pericardial fat depots were also predictive of long-term AF recurrence after ablation (p = 0.035). Finally, pericardial fat depots were also associated with left atrial volume (total pericardial fat: r = 0.46, p < 0.001). Importantly, these associations persisted after multivariate adjustment and additional adjustment for body weight. In contrast, however, systemic measures of adiposity, such as body mass index and body surface area, were not associated with these outcomes in multivariate-adjusted models.
CONCLUSIONS: Pericardial fat is associated with the presence of AF, the severity of AF, left atrial volumes, and poorer outcomes after AF ablation. These associations are both independent of and stronger than more systemic measures of adiposity. These findings are consistent with the hypothesis of a local pathogenic effect of pericardial fat on the arrhythmogenic substrate supporting AF.
Christopher X Wong; Hany S Abed; Payman Molaee; Adam J Nelson; Anthony G Brooks; Gautam Sharma; Darryl P Leong; Dennis H Lau; Melissa E Middeldorp; Kurt C Roberts-Thomson; Gary A Wittert; Walter P Abhayaratna; Stephen G Worthley; Prashanthan Sanders
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  57     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-22     Completed Date:  2011-06-20     Revised Date:  2011-11-03    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1745-51     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Centre for Heart Rhythm Disorders (CHRD), Royal Adelaide Hospital and the University of Adelaide, Adelaide, Australia.
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MeSH Terms
Adipose Tissue / pathology*
Atrial Fibrillation / diagnosis*,  surgery*
Catheter Ablation / methods*
Follow-Up Studies
Magnetic Resonance Imaging / methods
Middle Aged
Pericardium / pathology*
Severity of Illness Index*
Treatment Outcome
Comment In:
J Am Coll Cardiol. 2011 Oct 4;58(15):1640; author reply 1640-1   [PMID:  21958896 ]

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