Association between epicardial adipose tissue density and outcomes after persistent atrial fibrillation catheter ablation

Background Epicardial adipose tissue (EAT), through a paracrine secretion of various molecules, seems to be implicated in left atrial (LA) adverse remodelling, promoting persistent atrial fibrillation (PersAF). Computed tomography (CT) density appears to be a marker of EAT secretory activity. Purpose We sought to assess whether EAT density alone or combined with EAT volume is associated with the occurrence of PersAF after a first catheter ablation (CA) procedure. Methods This retrospective study included all consecutive patients undergoing a first CA procedure for PersAF in Nancy University Hospital in 2016 and 2017 with a one-year follow-up. Cardiac CT performed before the ablation allowed quantitative (volume) and qualitative (density) analysis of EAT. Results One hundred and seventy-seven patients were included. After adjustment, determinants of EAT volume were age (β = 0.97, P = 0.014), triglycerides level (β = 10.61, P = 0.002), LA area (β = 4.06, P  Conclusion EAT density assessed by cardiac CT seems to be correlated with the risk of recurrence after a first PersAF CA. EAT density might be useful to predict PersAF recurrence after CA and could also become a therapeutic target.