Correlation Of Epicardium Adipose Tissue Volume With Atrial Fibrillation Recurrence In Blank Period After First Radiofrequency Ablation

Objective:Studies have shown that epicardial adipose tissue volume is significantly correlated with the occurrence and maintenance of atrial fibrillation,and is significantly correlated with the recurrence of atrial fibrillation in the blank period after the first radiofrequency ablation.The purpose of this study was to measure the volume of epicardial adipose tissue in patients with recurrent and non-recurrent atrial fibrillation after the first radiofrequency ablation,and to investigate its correlation with recurrent atrial fibrillation after the first radiofrequency ablation.Methods:One hundred and three patients diagnosed with atrial fibrillation and underwent radiofrequency ablation were taken as the research objects in the First Affiliated Hospital of Jilin University from January 2018 and December 2019.Among them there 53 patients with persistent atrial fibrillation and 50 cases with paroxysmal atrial fibrillation.(1)All patients were recorded for their age,gender,height,weight,BMI,atrial fibrillation type,atrial fibrillation duration,hospital blood pressure,CHA2DS2-VASc score,history of diabetes,history of hypertension,history of smoking and drinking,blood biochemistry,blood lipid and other indicators.Follow-up data(postoperative antiarrhythmic drugs,number of postoperative blank period recurrence,follow-up time).(2)The diagnosis of atrial fibrillation and the indications for the implementation of the first radiofrequency ablation all met the standards of literature [3].The first radiofrequency ablation was performed.Preoperative routine transesophageal echocardiography and left atrial CTA examination were performed.The original left atrial CTA data was uploaded to the workstation,and the Volume software was used to analyze and measure the epicardial adipose tissue volume.(3)Body composition analysis,through the body composition analyzer [instrument model 5157021159(seca515)],using seca515 medical body composition analyzer(mBCA),measure the body fat weight,fat weight index,visceral fat,body fat rate,body fluids,composition,quality of skeletal muscle and waist circumference and other related data,and record the relevant data and statistics results.Results:(1)Recurrence rate of atrial fibrillation in blank period after the first rf ablation: among the 103 patients diagnosed with atrial fibrillation and treated with radiofrequency ablation for the first time,there were 24 patients with recurrence in blank period,and the recurrence rate in blank period was 23.3%(24/103).(2)Epicardial adipose tissue volume in the recurrence group of blank atrial fibrillation after the first radiofrequency ablation [144.47(139.82,148.73): 132.08(125.23,138.17),P<0.001] was significantly higher than that in the non-recurrence group.(3)Pearson correlation analysis of epicardium adipose tissue volume and related indicators: correlation analysis showed that there was no correlation between body fat rate and epicardial adipose tissue volume(r=-0.085,P=0.396),visceral fat and epicardial adipose tissue volume were positively correlated(r=0.441,P<0.001),fat weight was positively correlated with epicardial adipose tissue volume(r=0.351,P<0.001),and left atrial diameter was positively correlated with epicardial adipose tissue volume(r=0.265,P=0.007).(4)Independent risk factors for recurrence of atrial fibrillation in blank period after first radiofrequency ablation: multivariate Logistic regression analysis showed that the volume of pericardial adipose tissue(OR=1.176,95% ci 1.093-1.265,P<0.001)and duration of atrial fibrillation(OR=1.215,95%ci 1.004-1.472,P=0.045)in patients with atrial fibrillation were independent risk factors for recurrence of atrial fibrillation in blank period after first radiofrequency ablation.(5)ROC curve:(1)epicardial adipose tissue volume(EATV): the area under the curve was 0.864,the progressive 95% confidence interval,the lower limit was 0.796,the upper limit was 0.932,P=0.000,and the sensitivity and specificity of the prediction of atrial fibrillation recurrence in the blank stage after the first radiofrequency ablation were 100% and 70.9% when the cutoff value was 133.41 ml.(2)duration of atrial fibrillation(year): the area under the curve was 0.679,with a progressive 95% confidence interval,the lower limit was 0.550,the upper limit was 0.808,P=0.008,and the sensitivity and specificity of the prediction of atrial fibrillation recurrence in the blank period after the first radiofrequency ablation were 62.5% and 75.9% with the cut-off value of 3.25.Conclusion:(1)The recurrence rate of atrial fibrillation in the blank period after the first radiofrequency ablation was 23.3%.(2)The volume of epicardial adipose tissue in the group with recurrent atrial fibrillation in the blank period after the first radiofrequency ablation was significantly higher than that in the non-recurrent group,and the difference was statistically significant.(3)Epicardial adipose tissue volume was positively correlated with visceral fat,fat weight and left atrial diameter.(4)Epicardial adipose tissue volume and duration of atrial fibrillation are independent risk factors for recurrence of atrial fibrillation in the blank period after the first radiofrequency ablation,which have a good predictive value for atrial fibrillation recurrence in the blank period after the first radiofrequency ablation.