Relationship between epicardial adipose tissue volume and atrial fibrillation A systematic review and meta-analysis

Several studies have suggested that epicardial adipose tissue (EAT) volume may be associated with the risk of atrial fibrillation (AF). However, these studies have reported conflicting results. We therefore aimed to investigate the relationship between EAT volume and AF. We systematically retrieved the relevant studies reporting on the relationship between EAT volume and AF using the Cochrane Library, PubMed, Medline, EBSCO, and Embase databases. Data were extracted from applicable articles, and mean differences were pooled using the RevMan 5.3 software. Ten case-control studies were identified. With regard to the relationship between EAT volume and AF, both total-EAT volume (24.23 ml, 95 % CI: 19.40-29.06, p < 0.00001) and EAT volume surrounding the left atrium (LA-EAT; 16.35 ml, 95 %CI: 12.73-19.98, p < 0.00001) were significantly increased in patients with AF. With regard to the relationship between the different types of AF and EAT volume, there was a significant difference in the total-EAT volume subgroup (19.38 ml, 95 % CI: 11.45-27.31, p < 0.0001) and in the LA-EAT volume subgroup (17.91 ml, 95 % CI: 15.13-20.69, p < 0.00001) between patients with persistent AF (PeAF) and paroxysmal AF (PAF). However, there was no significant difference between the total-EAT and LA-EAT volume subgroups (chi (2) = 0.12, p = 0.70). EAT volume may be associated with an increased risk of AF. Additionally, the EAT volume in patients with PeAF was larger than that in PAF patients, independent of the location of EAT.