Author + information
- Received December 28, 2009
- Revision received March 3, 2010
- Accepted March 18, 2010
- Published online August 31, 2010.
- M. Obadah Al Chekakie, MD,
- Christine C. Welles, MD,
- Raymond Metoyer, BSRT,
- Ahmed Ibrahim, MD,
- Adam R. Shapira, MD,
- Joseph Cytron, MD,
- Peter Santucci, MD,
- David J. Wilber, MD and
- Joseph G. Akar, MD, PhD* ()
- ↵*Reprint requests and correspondence:
Dr. Joseph G. Akar, Section of Cardiovascular Medicine, Yale University School of Medicine, 333 Cedar Street, FMP 3, New Haven, Connecticut 06511
Objectives The purpose of this study was to investigate the association between atrial fibrillation (AF) and pericardial fat.
Background Pericardial fat is visceral adipose tissue that possesses inflammatory properties. Inflammation and obesity are associated with AF, but the relationship between AF and pericardial fat is unknown.
Methods Pericardial fat volume was measured using computed tomography in 273 patients: 76 patients in sinus rhythm, 126 patients with paroxysmal AF, and 71 patients with persistent AF.
Results Patients with AF had significantly more pericardial fat compared with patients in sinus rhythm (101.6 ± 44.1 ml vs. 76.1 ± 36.3 ml, p < 0.001). Pericardial fat volume was significantly larger in paroxysmal AF compared with the sinus rhythm group (93.9 ± 39.1 ml vs. 76.1 ± 36.3 ml, p = 0.02). Persistent AF patients had a significantly larger pericardial fat volume compared with paroxysmal AF (115.4 ± 49.3 ml vs. 93.9 ± 39.1 ml, p = 0.001). Pericardial fat volume was associated with paroxysmal AF (odds ratio: 1.11; 95% confidence interval: 1.01 to 1.23, p = 0.04) and persistent AF (odds ratio: 1.18, 95% confidence interval: 1.05 to 1.33, p = 0.004), and this association was completely independent of age, hypertension, sex, left atrial enlargement, valvular heart disease, left ventricular ejection fraction, diabetes mellitus, and body mass index.
Conclusions Pericardial fat volume is highly associated with paroxysmal and persistent AF independent of traditional risk factors including left atrial enlargement. Whether pericardial fat plays a role in the pathogenesis of AF requires future investigation.
Dr. Al Chekakie is on the Fellowship advisory council for Biotronik. Dr. Wilber has been an investigator for Medtronic, St. Jude Medical, Biosense Webster, and Cardio Insight, and has been a consultant for Biosense Webster and Cardio Insight. All other authors have reported that they have no relationships to disclose.
- Received December 28, 2009.
- Revision received March 3, 2010.
- Accepted March 18, 2010.
- American College of Cardiology Foundation