Abundant epicardial adipose tissue surrounding the left atrium predicts early rather than late recurrence of atrial fibrillation after catheter ablation

Epicardial adipose tissue (EAT) surrounding the left atrium has been reported to have a pro-arrhythmic influence on atrial myocardium and to play an important role in the pathophysiology of atrial fibrillation (AF). The purpose of this study was to explore whether the abundance of EAT correlates with early and late recurrences of AF after ablation. We included 53 consecutive patients with drug-refractory AF scheduled for ablation. Early and late recurrences were defined as atrial tachyarrhythmias within and after 3 months following the ablation procedure, respectively. The total and left atrial EAT volumes were obtained by 320-detector-row multislice computed tomography. During a follow-up period of 16 +/- 4 months, early and late recurrences occurred in 29 (55 %) and 12 (23 %) patients, respectively. The left atrial EAT volume was larger in patients with than without early recurrence (35.1 +/- 13.1 vs. 25.0 +/- 9.5 cm(3), p = 0.002); however, there was no difference in the total EAT volume between the two groups (98.5 +/- 45.7 vs. 94.5 +/- 35.2 cm(3), p = 0.72). A multivariate analysis revealed that a large left atrial EAT volume, persistent AF, and large left atrial volume were independent predictors of early recurrence. Conversely, there was no significant difference in left atrial (29.3 +/- 14.6 vs. 29.7 +/- 11.7 cm(3), p = 0.93) and total EAT (91.0 +/- 50.1 vs. 97.9 +/- 37.0 cm(3), p = 0.66) volumes between patients with and without late recurrence. The abundance of left atrial EAT independently predicted early recurrence after AF ablation; on the contrary, it did not have an impact on late recurrence. Left atrial EAT may have a pro-arrhythmic influence, especially in the early post-ablation phase.