Association Between Bradyarrhythmia Requiring Permanent Pacemaker Implantation and Epicardial Adipose Tissue in...

Aging is one of the most significant risk factors for sinus node (SN) and atrioventricular node (AVN) dysfunction. Epicardial adipose tissue (EAT) is reported to promote myocardial fibrosis and influence intracardiac conduction through the release of inflammatory cytokines and direct tissue infiltration. The SN and AVN are in contact with EAT, which may affect the SN function and AVN conduction. The purpose of this study was to examine the association between bradyarrhythmia and EAT.

We enrolled 103 patients with bradyarrhythmia requiring permanent pacemaker (PM) implantations and 105 patients who underwent catheter ablation of paroxysmal supraventricular tachycardia in our hospital as a control (all patients were over 65 years old) and analyzed the preoperative echocardiograms retrospectively and measured the EAT thickness. We compared the EAT thickness between the PM group and control.

There were 38 (36.9%) PM group patients with sick sinus syndrome and 65 (63.1%) with advanced atrioventricular block. The EAT was significantly thicker in the PM group than control (PM group 4.6 ± 1.2 mm vs. control 3.6 ± 1.3 mm, p < 0.0001). The EAT was also significantly thicker in the PM group than control (PM group 4.5 ± 1.2 mm vs. control 3.6 ± 1.3 mm, p = 0.0017) after propensity score matching (age, gender, hypertension, history of heart failure, left atrial diameter, and estimated glomerular filtration rate).

The EAT thickness was associated with bradyarrhythmia requiring permanent PM implantation and may become a risk factor for SN and AVN dysfunction in elderly people.