Association between epicardial adipose tissue and recurrence of atrial fibrillation after ablation: a propensity score-matched analysis

To assess the association between epicardial adipose tissue (EAT) index derived from cardiac computed tomography and atrial fibrillation (AF) recurrence after ablation by comparing with a propensity score matched non-recurrence AF patients. A total of 506 patients with AF recurrence and 174 patients without AF recurrence were enrolled in this retrospective study. Density and volume of total EAT surrounding the heart (Total-EAT) and EAT surrounding the left atrium (LA-EAT) were measured, propensity score matching(PSM) analyses were used to compare the outcomes of the two groups while controlling for confounders. Total-EAT density (HU) value (-81.27 +/- 4.67 vs -84.05 +/- 3.84, P < 0.001) and LA-EAT density (HU) value (-76.16 +/- 4.11 vs -78.83 +/- 3.81, P < 0.001) were significantly higher in the patients with AF recurrence than in those without recurrence. LA-EAT density (HU) value was significantly higher than Total-EAT (- 77.50 +/- 4.18 vs -82.66 +/- 4.49, P = 0.000). In a multiple logistic regression analysis, a higher LA-EAT density (odds ratio: 1.12; 95% CI: 1.02-1.22, p = 0.015) was significantly associated with the AF recurrence after adjusting for other risk factors. The LA-EAT density plays an important role in the AF recurrence after ablation. Assessment of LA-EAT density can improve ablation outcomes by refining patient selection.