Display options
Cite
Singhal R, Lo LW, Lin YJ, et al. Intrinsic Cardiac Autonomic Ganglionated Plexi within Epicardial Fats Modulate the Atrial Substrate Remodeling: Experiences with Atrial Fibrillation Patients Receiving Catheter Ablation. Acta Cardiol Sin. 2016;32(2):174-84doi: 10.6515/acs20150427a.
Singhal, R., Lo, L. W., Lin, Y. J., Chang, S. L., Hu, Y. F., Chao, T. F., Chung, F. P., Chiou, C. W., Tsao, H. M., & Chen, S. A. (2016). Intrinsic Cardiac Autonomic Ganglionated Plexi within Epicardial Fats Modulate the Atrial Substrate Remodeling: Experiences with Atrial Fibrillation Patients Receiving Catheter Ablation. Acta Cardiologica Sinica, 32(2), 174-84. https://doi.org/10.6515/acs20150427a
Singhal, Rahul, et al. "Intrinsic Cardiac Autonomic Ganglionated Plexi within Epicardial Fats Modulate the Atrial Substrate Remodeling: Experiences with Atrial Fibrillation Patients Receiving Catheter Ablation." Acta Cardiologica Sinica vol. 32,2 (2016): 174-84. doi: https://doi.org/10.6515/acs20150427a
Singhal R, Lo LW, Lin YJ, Chang SL, Hu YF, Chao TF, Chung FP, Chiou CW, Tsao HM, Chen SA. Intrinsic Cardiac Autonomic Ganglionated Plexi within Epicardial Fats Modulate the Atrial Substrate Remodeling: Experiences with Atrial Fibrillation Patients Receiving Catheter Ablation. Acta Cardiol Sin. 2016 Mar;32(2):174-84. doi: 10.6515/acs20150427a. PMID: 27122948; PMCID: PMC4816916.
Copy Download .nbib Format: NLM
Share it on

Acta Cardiol Sin. 2016 Mar;32(2):174-84. doi: 10.6515/acs20150427a.

Intrinsic Cardiac Autonomic Ganglionated Plexi within Epicardial Fats Modulate the Atrial Substrate Remodeling: Experiences with Atrial Fibrillation Patients Receiving Catheter Ablation.

Acta Cardiologica Sinica

Rahul Singhal, Li-Wei Lo, Yenn-Jiang Lin Lin, Shih-Lin Chang, Yu-Feng Hu, Tze-Fan Chao, Fa-Po Chung, Cheun-Wang Chiou, Hsuan-Ming Tsao, Shih-Ann Chen

Affiliations

  1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital;
  2. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital; ; Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei;
  3. Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei; ; National Yang-Ming University Hospital, ILan, Taiwan.

PMID: 27122948 PMCID: PMC4816916 DOI: 10.6515/acs20150427a

Abstract

BACKGROUND: A recent study reported the close relationship between high dominant frequent (DF) sites [atrial fibrillation (AF) nest] and the intrinsic cardiac autonomic nervous system. The aim of this study was to investigate the correlation between the regional distribution of epicardial fat and the properties of the biatrial substrates in AF patients.

METHODS: We studied 32 patients with paroxysmal (n = 23) and persistent (n = 9) AF. The epicardial fat volume around the left atrium (LA) was evaluated using 64-slice multidetector computed tomography and the topographic distribution of the fat volume was assessed. The biatrial DFs, voltages, and total activation times (TATs) were obtained during sinus rhythm.

RESULTS: Out of the 8 divided LA regions, a significant linear correlation existed between the LA fat and mean DF values in the right upper anterior LA, left upper anterior LA, right lower anterior LA, right upper posterior LA, left upper posterior LA, and left lower posterior LA. There was no significant correlation between the regional LA fat distribution and regional LA peak-to-peak bipolar voltage and TAT. During a mean follow-up of 17 ± 8 months, 22 of the 32 (69%) patients were free of AF. In the multivariate analysis, only the mean LA DF was found to be a significant predictor of recurrence.

CONCLUSIONS: There was a close association between the regional distribution of the LA epicardial fat and the atrial substrate manifesting high frequency during sinus rhythm (AF nest). Those nests were related to ablation outcome. Hence, epicardial fat may play a significant role in atrial substrate remodeling and thereby in the pathogenesis and maintenance of AF.

KEY WORDS: Atrial fibrillation • Dominant frequency • Epicardial fat • Nest • Recurrence.

References

  1. Am J Cardiol. 1995 Aug 15;76(5):414-8 - PubMed
  2. N Engl J Med. 1982 Apr 29;306(17):1018-22 - PubMed
  3. Anat Rec. 1997 Feb;247(2):289-98 - PubMed
  4. J Am Coll Cardiol. 2007 Jul 3;50(1):61-8 - PubMed
  5. J Am Coll Cardiol. 2010 Aug 31;56(10):784-8 - PubMed
  6. Circulation. 2008 Feb 5;117(5):605-13 - PubMed
  7. Europace. 2004 Nov;6(6):590-601 - PubMed
  8. N Engl J Med. 2002 Aug 1;347(5):305-13 - PubMed
  9. J Am Coll Cardiol. 2005 Jan 18;45(2):285-92 - PubMed
  10. Circulation. 2000 Nov 28;102(22):2774-80 - PubMed
  11. Circulation. 2004 Nov 2;110(18):2797-801 - PubMed
  12. Circ Res. 2009 Feb 27;104(4):541-9 - PubMed
  13. J Cardiovasc Electrophysiol. 2007 Jun;18(6):607-11 - PubMed
  14. Am J Cardiol. 2011 May 15;107(10):1498-503 - PubMed
  15. Heart Rhythm. 2006 Feb;3(2):201-8 - PubMed
  16. Heart Rhythm. 2008 Jul;5(7):968-74 - PubMed
  17. Circulation. 2009 Mar 31;119(12):1586-91 - PubMed
  18. Cytokine. 2005 Mar 21;29(6):251-5 - PubMed
  19. PLoS One. 2013 Sep 16;8(9):e74926 - PubMed
  20. J Am Coll Cardiol. 2005 Jun 7;45(11):1878-86 - PubMed
  21. J Cardiovasc Electrophysiol. 2005 Feb;16(2):173-80 - PubMed
  22. Thromb Res. 2003;111(3):137-42 - PubMed
  23. Circ J. 2014;78(4):922-8 - PubMed
  24. J Cardiovasc Electrophysiol. 2010 Mar;21(3):270-7 - PubMed
  25. Eur J Echocardiogr. 2006 Mar;7(2):79-108 - PubMed
  26. J Cardiovasc Electrophysiol. 2002 Jan;13(1):83-7 - PubMed
  27. J Cardiovasc Electrophysiol. 2009 Oct;20(10):1186-9 - PubMed
  28. Circulation. 2003 Nov 18;108(20):2460-6 - PubMed
  29. Circ Arrhythm Electrophysiol. 2010 Aug;3(4):345-50 - PubMed
  30. J Cardiovasc Electrophysiol. 2007 Mar;18(3):258-65 - PubMed
  31. Circulation. 1995 Oct 1;92(7):1954-68 - PubMed
  32. Eur Heart J. 2009 Apr;30(7):850-6 - PubMed

Publication Types