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 seen ventricular arrhythmias. Radiofrequency ablation is an effective treatment to improve symptoms and eliminate premature ventricular contractions. Epicardial adipose tissue is a true visceral adipose depot of the heart. A relation between an elevated epicardial adipose tissue thickness and myocardial structural pathologies. However, an association of EAT thickness with success rates for premature ventricular contractions ablation has not been investigated yet.
Aims: To assess the relation between the epicardial adipose tissue thickness and success rates for premature ventricular contraction ablation.
Study Design: Retrospective case-control study.
Methods: A total 106 consecutive patients who have had high premature ventricular contraction burden of >10,000/24-h using ambulatory Holter monitorization and underwent catheter ablation were enrolled in this study. A frequency of premature ventricular contractions of more than 10000 per day was defined as frequent premature ventricular contractions. Epicardial adipose tissue thickness was measured by using 2-D transthoracic echocardiography. A successful ablation was termed as over 80 % decrease in pre-procedural premature ventricular contraction attacks with the same morphology in 24-h Holter monitorization after 1-month follow-up visit from an ablation procedure.
Results: Successful premature ventricular contractions ablation was achieved in 87 (82.1%) patient. Epicardial adipose tissue thickness was importantly higher in unsuccessful ablation patients (p<0.001). Procedure time, total fluoroscopy time and radiofrequency ablation time were statistically higher in unsuccessful group (p<0.001). In stepwise multivariate logistic regression analyze, epicardial adipose tissue thickness and pseudodelta were independently associated with procedural success (both p values <0.001). In receiver operating curve (ROC) analysis, epicardial adipose tissue thickness was found to be an important predictor for procedural success (AUC=0.85, p = 0.001), with a cut-off value of 7.7 mm and sensitivity of 92% and specifity of 68%.
Conclusion: Our study findings suggested that epicardial adipose tissue thickness was greater in patients with premature ventricular contraction ablation failure, which was also found as a significant predictor of procedural success.

Keywords : Premature ventricular complexes, ablation, epicardial adipose tissue

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