{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T21:49:36Z","timestamp":1773092976103,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T00:00:00Z","timestamp":1589587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Epicardial adipose tissue (EAT) contributes to atrial fibrillation (AF). However, its impact on the efficacy of left atrial posterior wall isolation (LAPWI) is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010four nonparoxysmal AF patients underwent LAPWI after pulmonary vein isolation. EAT overlap on LAPWI was assessed by fusing computed tomography images with electro\u2010anatomical mapping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the 21\u00a0\u00b1\u00a07\u00a0months of follow\u2010up, AF recurred in 10 patients (23%). The total and left atrial EAT volumes were 113\u00a0\u00b1\u00a036 and 33\u00a0\u00b1\u00a012\u00a0cm<jats:sup>3<\/jats:sup>, respectively. No differences were found between the AF\u2010free and AF\u2010recurrent groups regarding EAT volume. The EAT overlaps on LAPWI lines and LAPWI area were 1.2\u00a0\u00b1\u00a01.0 and 0.5\u00a0\u00b1\u00a00.9\u00a0cm<jats:sup>2<\/jats:sup> respectively. Although no difference was found between groups regarding the EAT overlap on LAPWI area, the AF\u2010free group had a significantly larger EAT overlap on LAPWI lines (1.4\u00a0\u00b1\u00a01.0 vs 0.6\u00a0\u00b1\u00a00.6 cm<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.014). Multivariate analysis identified EAT overlap on LAPWI lines as an independent predictor of AF recurrence (hazard ratio: 0.399, 95% confidence interval: 0.178\u20100.891, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.025). Kaplan\u2010Meier analysis revealed that, during follow\u2010up, 92% of the large EAT overlap group (\u22651.0\u00a0cm<jats:sup>2<\/jats:sup>) and 58% of the small EAT overlap group (&lt;1.0\u00a0cm<jats:sup>2<\/jats:sup>) remained AF\u2010free (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EAT overlap on LAPWI lines is related to a high AF freedom rate. Direct radiofrequency application to EAT overlap may be necessary to suppress AF.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12359","type":"journal-article","created":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T13:54:05Z","timestamp":1589637245000},"page":"652-659","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Epicardial adipose tissue affects the efficacy of left atrial posterior wall isolation for persistent atrial fibrillation"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5427-5048","authenticated-orcid":false,"given":"Yosuke","family":"Nakatani","sequence":"first","affiliation":[{"name":"Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamotsu","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Tsujino","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Kinugawa","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine University of Toyama Toyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.09.089"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.116.004614"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw398"},{"issue":"22","key":"e_1_2_8_5_1","first-page":"132","article-title":"Is epicardial fat tissue associated with atrial fibrillation recurrence after ablation? 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