scholarly journals Impact of epicardial fat on the duration of radiofrequency energydelivery during catheter ablation of atrial fibrillation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
V Oudin ◽  
C Marcus ◽  
L Faroux ◽  
M Espinosa ◽  
D Metz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Multivariate Analysis ◽  
Catheter Ablation ◽  
Total Duration ◽  
Epicardial Fat ◽  
Funding Sources ◽  
Epicardial Fat Volume ◽  
The Impact ◽  
Fat Volume ◽  
Tomography Scan

Abstract Funding Acknowledgements Type of funding sources: None. Aims This study aimed to determine the impact of the volume of epicardial fat on the duration of radiofrequency (RF) energy delivery during the procedure of ablation of atrial fibrillation (AF). Methods The volume of epicardial fat was measured from spiral computerized tomography scan. The primary endpoint was the duration of RF delivery for pulmonary vein isolation (PVI), and the overall total duration of RF application. Secondary endpoint was conversion of AF to sinus rhythm or organisation of the arrhythmia after PVI. Results From March 2015 to May 2018, 222 patients (45,5% with persistent AF) underwent a first RF catheter ablation procedure for AF. The total duration of RF delivery, and the duration of RF delivery specifically for PVI were significantly associated with higher total volume of epicardial fat (p = 0,0002; p = 0,009 respectively), periatrial (p = 0,003; p = 0,045) and periventricular epicardial fat (p = 0,001; p = 0,012). In multivariate analysis, total epicardial fat volume was not significantly associated with total RF delivery duration (p = 0,743). For patients with arrhythmia at the time of the procedure, patients who achieved conversion or organisation of their arrhythmia after PVI had similar levels of total epicardial fat to those whose arrhythmia persisted (65 ± 35,2 vs 74,5 ± 31,2 ml ; p = 0,192). Conclusion We observed a significant relation between total, periatrial, and periventricular epicardial fat, and the duration of RF delivery during ablation of AF. This relation was not significant by multivariate analysis meaning that epicardial fat maybe a marker, but not an independent factor,of ablation complexity.

scholarly journals TOTAL EPICARDIAL FAT VOLUME IS ASSOCIATED WITH EARLY RECURRENCE OF ATRIAL FIBRILLATION AFTER CATHETER ABLATION

2012 ◽  
Vol 59 (13) ◽  
pp. E691 ◽  
Author(s):  
Chika Murakami ◽  
Takayuki Nagai ◽  
Fujii Akira ◽  
lio Chiharuko ◽  
Teruhito Kido ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Early Recurrence ◽  
Epicardial Fat ◽  
Epicardial Fat Volume ◽  
Fat Volume

scholarly journals Epicardial Fat Volume and the Risk of Atrial Fibrillation in the General Population Free of Cardiovascular Disease

2017 ◽  
Vol 10 (11) ◽  
pp. 1405-1407 ◽  
Author(s):  
Daniel Bos ◽  
Meike W. Vernooij ◽  
Rahil Shahzad ◽  
Maryam Kavousi ◽  
Albert Hofman ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
General Population ◽  
Epicardial Fat ◽  
Epicardial Fat Volume ◽  
Fat Volume

scholarly journals The impact of abnormal conduction zone on outcomes after catheter ablation for atrial fibrillation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T Mine ◽  
H Kishima ◽  
E Fukuhara ◽  
R Kitagaki ◽  
M Ishihara
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Univariate Analysis ◽  
Conduction Block ◽  
Right Atrial ◽  
Atrial Pacing ◽  
Funding Sources ◽  
Conduction Zone ◽  
A Site ◽  
The Impact

Abstract Background The abnormal conduction zone (ACZ) in the left atrium (LA) has attracted attention as an arrhythmia substrate in atrial fibrillation (AF). Purpose We investigated whether the ACZ affects outcomes after catheter ablation (CA) for AF. Methods We studied 78 patients (42 Non-paroxysmal AF, 49 males, and 68±10 years) who received CA for AF. High-density LA mapping during high right atrial pacing was constructed gaining than 2000 points (average 4377±846 points). Isochronal activation maps created at 5-ms interval setting. ACZ was identified by locating a site with isochronal crowding of ≥3 isochrones, and ≥8 isochrones were defined as the conduction block zone (CBZ) in a 4-mm diameter tag (conduction velocity were calculated as ≤27 cm/s and≤10 cm/s, respectively). Result Recurrent AF was detected in 25/78 patients (32%) during the follow-up period (9.2±3.0 month). ACZ and CBZ were distributed linearly, and ACZ was observed in 73 of 78 patients and 8 of these 73 patients had the CBZ. Univariate analysis revealed that elevated body mass index (26.2±3.8 vs. 24.3±3.3 kg/m2, P=0.0303), the higher prevalence of non-paroxysmal AF (72% vs. 45%, P=0.0272), larger LA diameter (47.6±6.6 vs. 42.1±6.9 mm, P=0.0014), and longer length of ACZ (79.7±45.1 vs. 52.9±35.7 mm, P=0.0058) were associated with recurrent AF after CA. On multivariate analysis, longer ACZ was independently associated with recurrent AF. Moreover, patients with longer ACZ (cutoff value: 84 mm) had a higher risk of recurrent AF than shorter ACZ (12/22; 55% vs 13/56; 23%, log-rank P=0.0024). Conclusion The length of ACZ was associated with recurrent AF after CA. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Epicardial Fat Volume as a New Imaging-Based Feature Associated with Risk of Recurrence after Pulmonary Veins Ablation in Atrial Fibrillation

2020 ◽  
Vol 5 (2) ◽  
pp. 65-70
Author(s):  
Emanuel Blîndu ◽  
Szilamér Korodi ◽  
Lehel Bordi ◽  
István Kovács ◽  
Imre Benedek
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Pulmonary Veins ◽  
High Rate ◽  
Epicardial Fat ◽  
Atrial Volume ◽  
Ct Analysis ◽  
Epicardial Fat Volume ◽  
Fat Volume ◽  
Af Recurrence

AbstractBackground: Atrial fibrillation (AF), a common arrhythmia in clinical practice, is associated with a high rate of complications and an increased risk for thromboembolic events. Pulmonary vein ablation is a new therapeutic option to cure AF; however, it remains associated with a high rate of recurrence. In this study we aimed to identify the clinical characteristics and imaging-based features that may predict the risk of recurrence after pulmonary veins ablation in atrial fibrillation.Materials and method: Twenty-four patients with paroxysmal and persistent AF, who underwent radiofrequency catheter ablation and a 12-month follow-up were included in the study. Group 1 included 8 patients with AF recurrence, and group 2 included 16 patients with no AF recurrence. In all cases, cardiovascular risk factors, ejection fraction, left atrial diameter, atrial volumes, and epicardial fat volume were analyzed.Results: CT analysis revealed that patients with AF recurrence presented a significantly larger mean index of left atrial volume (59.57 ± 8.52 mL/m2 vs. 49.99 ± 10.88 mL/m2, p = 0.04), right atrial volume (58.94 ± 8.37 mL/m2 vs. 43.21 ± 6.4 mL/m2, p<0.0001), and indexed bi-atrial volume (118.5 ± 15.82 mL/m2 vs. 93.19 ± 16.42 mL/m2, p = 0.005). At the same time, CT analysis of the epicardial adipose tissue volume indicated that patients with AF recurrence have a larger amount of epicardial fat than those without AF recurrence (176.4 ± 100.8 mL vs. 109.8 ± 40.73 mL, p = 0.02).Conclusion: Left atrial diameter, indexed atrial volumes, and epicardial fat volume may be used as factors to identify patients at risk for developing recurrence after pulmonary vein ablation.

scholarly journals Impact of catheter ablation on functional tricuspid regurgitation in patients with atrial fibrillation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Nishiwaki ◽  
S Watanabe ◽  
F Yoneda ◽  
M Tanaka ◽  
A Komasa ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Tricuspid Regurgitation ◽  
Right Atrial ◽  
Main Role ◽  
Funding Sources ◽  
Functional Tricuspid Regurgitation ◽  
Significant Difference ◽  
One Year ◽  
The Impact

Abstract Background Since atrial functional tricuspid regurgitation (AF-TR) is associated with increased heart failure and mortality, the management of AF-TR is clinically important. Atrial fibrillation (AF) plays the main role in AF-TR. However, the effectiveness of catheter ablation (CA) and mechanism of improvement of AF-TR haven't been fully evaluated. Purpose We sought to investigate the impact of CA for AF on AF-TR in patients with moderate or more TR. Methods We retrospectively investigated consecutive 2685 patients with AF who received CA from February 2004 to December 2019 in Japan. The current study population consisted of 102 patients with moderate or greater TR who underwent CA for AF. The echocardiographic parameters were compared between pre-ablation and post-ablation transthoracic echocardiography (TTE), and the recurrence rate of AF/ atrial tachycardia (AT) was measured. Results The mean age was 73.2 years, 53% were women. TR severity and TR jet area significantly improved after CA for AF (TR jet area: 5.8 [3.9–7.6] cm2 to 2.0 [1.1–3.0] cm2, p&lt;0.001). In addition, mitral regurgitation (MR) jet area, left atrial (LA) area, mitral valve diameter, right ventricular (RV) end-diastolic area, right atrial (RA) area, tricuspid valve (TV) diameter decreased after CA (p&lt;0.001, &lt;0.001, &lt;0.001, = 0.02, &lt;0.001, and &lt;0.001, respectively). There was no significant difference between one-year recurrence of AF/AT and TR severity at pre-ablation TTE (moderate 28.6%, moderate to severe 37.2%, and severe 31.6%, p=0.72). Conclusions TR severity and jet area improved after CA in patients with AF and moderate or more TR. RV size, RA size, TV diameter also decreased after CA, which may be associated with TR improvement. There was no significant difference between one-year recurrence of AF/AT and TR severity at pre-ablation TTE. FUNDunding Acknowledgement Type of funding sources: None.

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