TY - JOUR
T1 - Impact of Nonalcoholic Fatty Liver Disease on Arrhythmia Recurrence Following Atrial Fibrillation Ablation
AU - Donnellan, Eoin
AU - Cotter, Thomas G.
AU - Wazni, Oussama M.
AU - Elshazly, Mohamed B.
AU - Kochar, Arshneel
AU - Wilner, Bryan
AU - Patel, Divyang
AU - Kanj, Mohamed
AU - Hussein, Ayman
AU - Baranowski, Bryan
AU - Cantillon, Daniel
AU - Griffin, Brian
AU - Jaber, Wael
AU - Saliba, Walid I.
N1 - Publisher Copyright:
© 2020 American College of Cardiology Foundation
PY - 2020/10
Y1 - 2020/10
N2 - Objectives: This study sought to investigate the association between nonalcoholic fatty liver disease (NAFLD) and arrhythmia recurrence following atrial fibrillation ablation; and to examine the impact of NAFLD stage on outcomes. Background: Metabolic derangements, including obesity and diabetes, are associated with incident and recurrent atrial fibrillation (AF), in addition to the development of NAFLD. Methods: This was a retrospective study of 267 consecutive patients undergoing AF ablation, 89 of whom were diagnosed with NAFLD prior to ablation and matched in a 2:1 manner based on age, sex, body mass index, ejection fraction, and AF type with 178 patients without NAFLD. Patients were monitored for arrhythmia recurrence during a mean follow-up of 29 months. Results: Recurrent arrhythmia was observed in 50 (56%) patients with NAFLD compared with 37 (21%) without NAFLD. Epicardial fat volume was measured on computed tomography and was significantly higher among those with NAFLD (248 ± 125 ml vs. 223 ± 97 ml; p = 0.01). On multivariable models adjusting for sleep apnea, body mass index, heart failure, AF type, and left atrial size, NAFLD was independently associated with increased rates of arrhythmia recurrence (hazard ratio: 3.010; 95% confidence interval: 1.980 to 4.680; p < 0.0001). Conclusions: NAFLD is associated with significantly increased arrhythmia recurrence rates following AF ablation. Identification and reversal, where possible, may result in improved arrhythmia-free survival.
AB - Objectives: This study sought to investigate the association between nonalcoholic fatty liver disease (NAFLD) and arrhythmia recurrence following atrial fibrillation ablation; and to examine the impact of NAFLD stage on outcomes. Background: Metabolic derangements, including obesity and diabetes, are associated with incident and recurrent atrial fibrillation (AF), in addition to the development of NAFLD. Methods: This was a retrospective study of 267 consecutive patients undergoing AF ablation, 89 of whom were diagnosed with NAFLD prior to ablation and matched in a 2:1 manner based on age, sex, body mass index, ejection fraction, and AF type with 178 patients without NAFLD. Patients were monitored for arrhythmia recurrence during a mean follow-up of 29 months. Results: Recurrent arrhythmia was observed in 50 (56%) patients with NAFLD compared with 37 (21%) without NAFLD. Epicardial fat volume was measured on computed tomography and was significantly higher among those with NAFLD (248 ± 125 ml vs. 223 ± 97 ml; p = 0.01). On multivariable models adjusting for sleep apnea, body mass index, heart failure, AF type, and left atrial size, NAFLD was independently associated with increased rates of arrhythmia recurrence (hazard ratio: 3.010; 95% confidence interval: 1.980 to 4.680; p < 0.0001). Conclusions: NAFLD is associated with significantly increased arrhythmia recurrence rates following AF ablation. Identification and reversal, where possible, may result in improved arrhythmia-free survival.
KW - atrial fibrillation ablation
KW - diabetes
KW - nonalcoholic fatty liver disease
KW - obesity
KW - risk factor modification
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U2 - 10.1016/j.jacep.2020.05.023
DO - 10.1016/j.jacep.2020.05.023
M3 - Article
C2 - 33092755
AN - SCOPUS:85090058082
SN - 2405-500X
VL - 6
SP - 1278
EP - 1287
JO - JACC: Clinical Electrophysiology
JF - JACC: Clinical Electrophysiology
IS - 10
ER -