We retrospectively identified regions of EAT around the LA and measured the density of these areas using computed tomography (CT).
A total of 32 patients who underwent their first catheter ablation for paroxysmal AF (PAF) were enrolled (mean age 62.5 ± 11.1 years). Patients without a history of AF (n = 32), but who underwent cardiac CT and were matched by age, sex, and metabolic risk factors, were enrolled in the control group (62.2 ± 12.1 years). The mean EAT density around the LA was significantly higher in the PAF group than in the control group (−108.1 ± 6.7 vs. −111.6 ± 5.5 Hounsfield units; p = 0.02), while the densities of subcutaneous adipose tissue (SAT) in the abdomen and thorax did not differ between the two groups. In a multiple logistic regression analysis, a higher EAT density was significantly associated with the presence of PAF after adjusting for other risk factors (odds ratio: 1.25; 95% confidence interval: 1.08–1.45, p = 0.003).
This study supports the hypothesis that inflammation of EAT around the LA, but not SAT, is related to the presence of PAF.