Wang Zhe, Wang Yijia, Chen Jiawei, Guo Hehe, Ren Lichen, Chen Xiaojie, Chen Yingwei, Sun Yihong
Department of Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, 100029 Beijing, China.
Department of Cardiology, Beijing Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100029 Beijing, China.
Rev Cardiovasc Med. 2023 Jun 30;24(7):189. doi: 10.31083/j.rcm2407189. eCollection 2023 Jul.
Epicardial adipose tissue (EAT) thickness is an independent predictor for the recurrence of premature ventricular beats after ablation. However, it is unclear whether EAT volume is associated with the recurrence of idiopathic ventricular tachycardia (IVT) following ablation. This study sought to investigate the association between EAT volume and IVT recurrence following radiofrequency ablation for IVT patients.
This retrospective study included 69 IVT patients undergoing computed tomography examination before ablation who underwent their first catheter ablation between 2017 and 2021. The predictive value of EAT volume for IVT recurrence following ablation was assessed.
During the follow-up period (median: 540 days; range: 253-929 days), 26.1% (18/69) of the patients experienced IVT recurrence. The cut-off point of EAT volume for predicting IVT recurrence was 160.30 mL, and the area under the curve (AUC) was 0.751 (95% confidence interval (CI): 0.615-0.887) by the receiver operating characteristic curve. Kaplan-Meier analysis showed that patients with larger EAT volumes had higher cumulative rates of IVT recurrence. Multivariable analysis also revealed that EAT volume (per 10 mL increase; hazard ratio (HR): 1.16, 95% CI: 1.03-1.32, = 0.018) was independently associated with IVT recurrence. Furthermore, patients with an epicardial site of IVT had a significantly larger EAT volume than IVT patients with non-epicardial origins.
A larger EAT volume may be associated with IVT recurrence after catheter ablation. EAT volume may be helpful for risk stratification in patients undergoing IVT ablation.
心外膜脂肪组织（EAT）厚度是消融术后室性早搏复发的独立预测因素。然而，目前尚不清楚EAT体积是否与特发性室性心动过速（IVT）消融术后的复发有关。本研究旨在探讨IVT患者射频消融术后EAT体积与IVT复发之间的关系。
本回顾性研究纳入了69例在2017年至2021年间接受首次导管消融的IVT患者，这些患者在消融前均接受了计算机断层扫描检查。评估了EAT体积对消融术后IVT复发的预测价值。
在随访期间（中位数：540天；范围：253 - 929天），26.1%（18/69）的患者出现IVT复发。预测IVT复发的EAT体积截断点为160.30 mL，通过受试者工作特征曲线分析，曲线下面积（AUC）为0.751（95%置信区间（CI）：0.615 - 0.887）。Kaplan-Meier分析显示，EAT体积较大的患者IVT复发的累积率更高。多变量分析还显示，EAT体积（每增加10 mL；风险比（HR）：1.16，95% CI：1.03 - 1.32，P = 0.018）与IVT复发独立相关。此外，IVT起源于心外膜的患者的EAT体积明显大于非心外膜起源的IVT患者。
较大的EAT体积可能与导管消融术后IVT复发有关。EAT体积可能有助于IVT消融患者的风险分层。
