Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(10), 1244–1252. https://doi.org/10.1002/clc.24081 Dr. Zhe Wang et al.
Points
- The study aimed to explore the link between pericoronary adipose tissue attenuation (PCATA) and atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA).
- Patients undergoing their initial RFCA for AF between 2018 and 2021 who had undergone coronary computed tomography angiography before the procedure were included in the study.
- PCATA of the right coronary artery (RCA) emerged as an independent risk factor for AF recurrence during the 1-year follow-up period, with 34.1% of patients experiencing recurrence.
- Patients with elevated levels of RCA-PCATA demonstrated a heightened risk of AF recurrence, even after adjusting for other risk factors, supporting the potential of PCATA as a valuable marker for risk stratification.
- The study showed that incorporating RCA-PCATA into the clinical model significantly improved the prediction of AF recurrence, as indicated by an increased area under the curve (AUC), relative integrated discrimination improvement (IDI), and continuous net reclassification improvement (NRI).
Summary
In this study, the researchers investigated the role of pericoronary adipose tissue attenuation (PCATA) in the recurrence of atrial fibrillation (AF) following radiofrequency catheter ablation (RFCA). Recognizing the crucial involvement of inflammation in AF occurrence and progression, the specific connection between PCATA and AF recurrence post-ablation remained unclear. The research, conducted between 2018 and 2021, enrolled patients who underwent their initial RFCA for AF and underwent coronary computed tomography angiography before the procedure.
During the 1-year follow-up period, 34.1% of patients experienced AF recurrence. The multivariable analysis identified PCATA of the right coronary artery (RCA) as an independent risk factor for AF recurrence. Patients exhibiting a high level of RCA-PCATA demonstrated an elevated risk of recurrence, even after adjusting for other risk factors using restricted cubic splines. The inclusion of RCA-PCATA as a marker significantly enhanced the predictive performance of the clinical model, as evidenced by an increased area under the curve (AUC) of 0.724 compared to 0.686 (p = .024). The relative integrated discrimination improvement (IDI) and continuous net reclassification improvement (NRI) further supported the improved predictive ability, with a relative IDI of 0.043 (p = .006) and continuous NRI of 0.521 (p < .001).
In conclusion, the study establishes an independent association between PCATA of the right coronary artery and AF recurrence post-ablation. The findings suggest that PCATA could serve as a valuable tool for risk stratification in patients undergoing AF ablation, thereby contributing to enhanced clinical decision-making in managing this cardiac arrhythmia.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24081
References Wang, Z., Wang, Y., Chen, J., Ren, L., Guo, H., Chen, X., Dong, J., Chen, Y., & Sun, Y. (2023). Impact of pericoronary adipose tissue attenuation on recurrence after radiofrequency catheter ablation for atrial fibrillation. Clinical Cardiology, 46(10), 1244–1252. https://doi.org/10.1002/clc.24081
