The predictive value of left atrium epicardial adipose tissue on recurrence after catheter ablation in patients with different types of atrial fibrillation

Background A growing body of evidence supports that the left atrium epicardial adipose tissue (LA-EAT) is related to the occurrence and recurrence of atrial fibrillation (AF). The relationship between LA-EAT and the recurrence after radiofrequency catheter ablation (RFCA) in patients with different types of AF is still unclear. This study aims to evaluate the predictive value of LA-EAT on the recurrence of AF after RFCA in patients with different types of AF. Methods 301 AF patients who underwent RFCA for the first time were divided into the paroxysmal atrial fibrillation (PAF) group (n = 181) and the persistent atrial fibrillation (PersAF) group(n = 120), which were followed up at 3, 6, and 12 months. All patients underwent left atrial computed tomography angiography (CTA) examination before the operation, and LA-EAT was measured using software (Advantage Workstation4.6, GE, USA). Results After a median follow-up of 10.7 months, 73/301 patients (24.25%) had a recurrence of AF, including 43 /120(35.83%) patients with PersAF and 30/181(16.57%) patients with PAF. In multivariable Cox regression analysis, LA-EAT volume (OR = 1.053;95%CI: 1.024–1.083, p < 0.001), attenuation (OR = 0.949;95%CI:0.911–0.988, p = 0.012) and left atrial diameter (LAD) (OR = 1.063;95%CI:1.002–1.127，p = 0.043) were independent risk factors for recurrence in patients with PersAF but not in patients with PAF. Conclusion LA-EAT volume and attenuation are independent risk factors for recurrence after RFCA in patients with PersAF.