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Peri-Atrial Adipose Tissue Inflammation in Atrial Fibrillation: Quantification of Electrophysiological Effects Using
Keeran Vickneson1, Ali Gharaviri1, Vinush Vigneswaran1
1Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland, United Kingdom.
JACC. Clinical Electrophysiology
|June 12, 2025
Summary
Increased peri-atrial adipose tissue volume is linked to atrial fibrillation (AF). This fat accumulation and reduced attenuation correlate with adverse atrial electrical remodeling in AF patients.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- Peri-atrial adipose tissue (PAAT) volume and attenuation, measurable by cardiac computed tomography angiography (CTA), are increased in atrial fibrillation (AF) patients.
- The electrophysiological significance of PAAT volume and attenuation in AF remains unclear.
Purpose of the Study:
- To investigate the spatial relationship between PAAT characteristics and atrial electrophysiological remodeling.
- To determine if PAAT volume and attenuation correlate with atrial voltage and conduction velocity.
Main Methods:
- Cardiac CTA was performed on 44 AF patients and 37 controls.
- Left atrial bipolar voltage and conduction velocity were co-registered with CTA-derived PAAT segmentations.
- PAAT volume and attenuation were compared with local electrical measurements.
Main Results:
- AF patients had greater PAAT volume (20.9 cm³ vs 14.2 cm³), independent of other factors.
- Higher PAAT burden in AF patients correlated with lower atrial voltage and conduction velocity.
- Low PAAT attenuation weakly correlated with reduced atrial voltage and conduction velocity in AF patients.
Conclusions:
- Peri-atrial adipose tissue volume is significantly greater in patients with atrial fibrillation.
- Increased PAAT burden and reduced attenuation are spatially, though weakly, correlated with adverse atrial electrophysiological remodeling in AF.
