Abstract 14623: Role of Left Atrial Epicardial Adipose Tissue in the Electrophysiologic Substrate for Atrial Fibrillation

BackgroundEpicardial adipose tissue (EAdT) appears to contribute to atrial fibrillation (AF) pathogenesis through the release of inflammatory cytokines and its rich innervation with ganglionated plexi. The electrophysiological mechanisms that mediate the association between EAdT and AF remain unclear, especially the association of EAdT with directly adjacent myocardial substrate.Methods and ResultsWe studied 30 consecutive patients who underwent cardiac computed tomography as well as electro-anatomical mapping in sinus rhythm prior to an initial AF ablation procedure. After image segmentation, atrial EAdT was anatomically registered to the voltage map (Figure). Patient age (-0.01 mV per year), and presence of EAdT (-0.29 mV) were associated with local myocardial log bipolar voltage in a multivariable regression model with clustering of data by patient.ConclusionIn the setting of AF, myocardial bipolar voltage was negatively associated with age and the presence of overlying EAdT. The arrhythmogenic properties of EAdT may be mediated through structural effects upon the atria.Figure