LAUSR

BACKGROUND Cardiac sympathetic nerve activity (CSNA) and epicardial adipose tissue (EAT) are known to be major determinants in the progression of atrial fibrillation (AF). OBJECTIVE The aim was to investigate the relationship between the combination of CSNA and EAT, and AF recurrence (AFR) following 3 months after the index catheter ablation (CA) in patients without heart failure (HF). METHODS AND RESULTS Sixty-four paroxysmal AF patients without HF were studied. Cardiac metaiodobenzylguanidine (MIBG) scintigraphy was performed at baseline and 3 months post-ablation. In MIBG imaging, the MIBG washout rate (WR) was calculated. The volumes of the total EAT and periatrial EAT surrounding the left atrium were measured by computed tomography before CA, and the periatrial to total EAT volume ratio (P/T) was obtained. During the follow-up period of 11 ± 4 months, AFR was observed in 14 patients. The WR change from baseline to 3 months after CA (dWR) and P/T were significantly greater in patients with than without AFR. Greater dWR and P/T determined by ROC curve analysis were independently associated with AFR. Patients with both greater dWR (≥6.9%) and P/T (≥17.1%) had a higher risk of AFR than those with either and none of them. Periatrial EAT volume showed a significant correlation with the baseline WR. CONCLUSIONS The combination of dWR and P/T was associated with AFR in patients without HF. Thus, both of CSNA and EAT might be related to development of AF.