Epicardial Adipose Tissue and Atrial Fibrillation Recurrence following Catheter Ablation: A Systematic Review and Meta-Analysis

Autor: Ioannis Anagnostopoulos, Maria Kousta, Charalampos Kossyvakis, Nikolaos Taxiarchis Paraskevaidis, Dimitrios Vrachatis, Spyridon Deftereos, Georgios Giannopoulos
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Clinical Medicine, Vol 12, Iss 19, p 6369 (2023)
Druh dokumentu: article
ISSN: 2077-0383
DOI: 10.3390/jcm12196369
Popis: (1)Introduction: Catheter ablation has become a cornerstone for the management of patients with atrial fibrillation (AF). Nevertheless, recurrence rates remain high. Epicardial adipose tissue (EAT) has been associated with AF pathogenesis and maintenance. However, the literature has provided equivocal results regarding the relationship between EAT and post-ablation recurrence.(2) Purpose: to investigate the relationship between total and peri-left atrium (peri-LA) EAT with post-ablation AF recurrence. (3) Methods: major electronic databases were searched for articles assessing the relationship between EAT, quantified using computed tomography, and the recurrence of AF following catheter ablation procedures. (4) Results: Twelve studies (2179 patients) assessed total EAT and another twelve (2879 patients) peri-LA EAT. Almost 60% of the included patients had paroxysmal AF and recurrence was documented in 34%. Those who maintained sinus rhythm had a significantly lower volume of peri-LA EAT (SMD: −0.37, 95%; CI: −0.58–0.16, I2: 68%). On the contrary, no significant difference was documented for total EAT (SMD: −0.32, 95%; CI: −0.65–0.01; I2: 92%). No differences were revealed between radiofrequency and cryoenergy pulmonary venous isolation. No publication bias was identified. (5) Conclusions: Only peri-LA EAT seems to be predictive of post-ablation AF recurrence. These findings may reflect different pathophysiological roles of EAT depending on its location. Whether peri-LA EAT can be used as a predictor and target to prevent recurrence is a matter of further research.
Databáze: Directory of Open Access Journals
Nepřihlášeným uživatelům se plný text nezobrazuje