ISSN : 2146-3123
E-ISSN : 2146-3131

Effect of Echocardiographic Epicardial Adipose Tissue Thickness on Success Rates of Premature Ventricular Contraction Ablation
Selçuk Kanat1, Bilge Duran Karaduman2, Ahmet Tütüncü1, Erhan Tenekecioğlu1, Ferit Onur Mutluer3, Nihal Akar Bayram4
1Clinic of Cardiology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
2Clinic of Cardiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
3Department of Cardiology, Koç University Hospital, İstanbul, Turkey
4Department of Cardiology, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
DOI : 10.4274/balkanmedj.galenos.2019.2019.4.88

Background: Idiopathic premature ventricular contractions are frequently detected ventricular arrhythmias, and radiofrequency ablation is an effectively treatment for improving symptoms and eliminating premature ventricular contractions. Furthermore, epicardial adipose tissue comprises a true visceral adipose deposit of the heart. Studies have reported a relationship between an elevated epicardial adipose tissue thickness and myocardial structural pathologies. However, the association between epicardial adipose tissue thickness and success rates of premature ventricular contraction ablation has not yet been investigated.
Aims: To assess the relationship between epicardial adipose tissue thickness and success rates of premature ventricular contraction ablation.
Study Design: Retrospective case-control study.
Methods: This study enrolled a total of 106 consecutive patients who have had a high premature ventricular contraction burden of >10,000/24-h assessed using ambulatory Holter monitorization andunderwent catheter ablation. A frequency of premature ventricularcontractions of more than 10,000/day was defined as frequentpremature ventricular contraction. Epicardial adipose tissue thicknesswas measured using 2D transthoracic echocardiography. A successfulablation was defined as >80% decrease in pre-procedural prematureventricular contraction attacks with the same morphology during 24-h Holter monitorization after a 1-month follow-up visit from an ablation procedure.
Results: Successful premature ventricular contraction ablation was achieved in 87 (82.1%) patients. Epicardial adipose tissue thickness was significantly higher in patients with unsuccessful ablation (p<0.001). Procedure time, total fluoroscopy time, and radiofrequency ablation time were statistically higher in the unsuccessful group (p<0.001). Stepwise multivariate logistic regression analysis showed that epicardial adipose tissue thickness and pseudo-delta wave time were independently associated with procedural success (both p values <0.001). In the receiver-operating curve analysis, epicardial adipose tissue thickness was found to be an important predictor for procedural success (area under the receiver-operating characteristic curve= 0.85, p=0.001), with a cutoff value of 7.7 mm, a sensitivity of 92%, and a specificity of 68%.
Conclusion: The findings of this study suggested that epicardial adipose tissue thickness was greater in patients with premature ventricular contraction ablation failure, which was also found to be a significant predictor of procedural success.

Keywords : Ablation, epicardial adipose tissue, premature ventricular complexes
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