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Cited 7 time in webofscience Cited 8 time in scopus
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Association between epicardial adipose tissue and embolic stroke after catheter ablation of atrial fibrillation

Authors
Ahn, JinheeShin, Seung YongShim, JaeminKim, Young-HoonHan, Sang-JinChoi, Eue-KeunOh, SeilShin, Ji YeonChoe, Jeong CheonPark, Jin SupLee, Hye WonOh, Jun-HyokChoi, Jung HyunLee, Han-CheolCha, Kwang SooHong, Taek JongLip, Gregory Y. H.Lim, Hong Euy
Issue Date
Nov-2019
Publisher
Blackwell Publishing Inc.
Keywords
atrial fibrillation; catheter ablation; epicardial adipose tissue; stroke
Citation
Journal of Cardiovascular Electrophysiology, v.30, no.11, pp 2209 - 2216
Pages
8
Indexed
SCI
SCIE
SCOPUS
Journal Title
Journal of Cardiovascular Electrophysiology
Volume
30
Number
11
Start Page
2209
End Page
2216
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/1440
DOI
10.1111/jce.14154
ISSN
1045-3873
1540-8167
Abstract
Introduction Risk factors of embolic stroke (ES) after atrial fibrillation (AF) ablation have not been fully elucidated especially among the Asian subjects, particularly regarding epicardial adipose tissue (EAT) in cardiac imaging. We aimed to assess the incidence of ES during a long-term follow-up period after AF ablation and to identify the risk factors associated with postablation ES, specifically focusing on EAT. Methods and Results We enrolled patients who experienced postablation ES and control subjects from a consortium of AF ablation registries from three institutes in Korea. EAT was assessed using multislice computed tomography before AF ablation. A total of 3464 patients who underwent AF ablation were recruited and followed-up. During a follow-up of 47.2 ± 36.4 months, ES occurred in 47 patients (1.36%) with a CHA2DS2-VASc score of 1.48 ± 1.39 and the overall annual incidence of ES was 0.34%. Compared with the control group (n = 190), the ES group showed significantly higher prior thromboembolism (TE) and AF recurrence rates, larger left atrium size, lower creatinine clearance rate (CCr), and greater total and peri-atrial EAT volume. Multivariate regression analysis demonstrated larger peri-atrial EAT volume (hazards ratio, 1.065; 95% confidence interval, 1.005-1.128), in addition to a prior history of TE and lower CCr, was independently associated with postablation ES. When a cut-off value of peri-atrial EAT volume of ≥20.15 mL was applied, patients with smaller peri-atrial EAT volume showed significantly higher ES-free survival. Conclusion Larger peri-atrial EAT volume, in addition to prior TE and lower CCr, was independently associated with postablation ES regardless of AF recurrence and CHA2DS2-VASc score. (ClinicalTrials.gov number, NCT03479073).
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Kim, Young Hoon
Anam Hospital (Department of Cardiology, Anam Hospital)
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