Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/66213
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Type: Journal article
Title: Pericardial fat is associated with atrial fibrillation severity and ablation outcome
Author: 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.
Citation: Journal of the American College of Cardiology, 2011; 57(17):1745-1751
Publisher: Elsevier Science Inc
Issue Date: 2011
ISSN: 0735-1097
1558-3597
Statement of
Responsibility: 
Christopher X. Wong, Hany S. Abed, Payman Molaee, Adam J. Nelson, Anthony G. Brooks, Gautam Sharma, Darryl P. Leong, Dennis H. Lau, Melissa E. Middeldorp, Kurt C. Roberts-Thomson, Gary A. Wittert, Walter P. Abhayaratna, Stephen G. Worthley, Prashanthan Sanders
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.
Keywords: atrial fibrillation; magnetic resonance imaging; obesity; pericardial fat
Rights: © 2011 by the American College of Cardiology Foundation
RMID: 0020106659
DOI: 10.1016/j.jacc.2010.11.045
Appears in Collections:Medicine publications

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