Pericardial fat is associated with atrial fibrillation severity and ablation outcome

Christopher Wong, Hany Abed, Payman Molaee, Adam Nelson, Anthony Brooks, Gautam Sharma, Darryl Leong, Dennis Lau, Melissa Middeldorp, Kurt Roberts-Thomson, Gary Wittert, Walter Abhayaratna, Stephen Worthley, Prashanthan Sanders

    Research output: Contribution to journalArticle

    245 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)1745-1751
    Number of pages7
    JournalJournal of The American College of Cardiology
    Volume57
    Issue number17
    DOIs
    Publication statusPublished - 2011

    Fingerprint Dive into the research topics of 'Pericardial fat is associated with atrial fibrillation severity and ablation outcome'. Together they form a unique fingerprint.

  • Cite this

    Wong, C., Abed, H., Molaee, P., Nelson, A., Brooks, A., Sharma, G., Leong, D., Lau, D., Middeldorp, M., Roberts-Thomson, K., Wittert, G., Abhayaratna, W., Worthley, S., & Sanders, P. (2011). Pericardial fat is associated with atrial fibrillation severity and ablation outcome. Journal of The American College of Cardiology, 57(17), 1745-1751. https://doi.org/10.1016/j.jacc.2010.11.045