The goal of this study was to retrospectively investigate the relationships between pericardial fat, left atrium volume (LAV) as measured on multidetector row computed tomography (MDCT) and persistent atrial fibrillation (AF) using a case-control study.

The study population consisted of 58 patients (19 men, 39 women; mean age, 67.8±10 [SD] years) with persistent AF and 74 control subjects (30 men, 44 women; mean age, 67.8±10.9 [SD] years). The associations between the presence of persistent AF and periatrial pericardial fat volume (PAFV), periatrial pericardial fat thickness (PAFT), and LAV as measured on MDCT were searched for using univariate and multiple linear regression analysis.

On univariate analysis, significant differences were found between patients with AF and control subjects for mean PAFV (54.33cm³±23.43 [SD]; range: 12.2–111.1cm³ vs 42.99cm³±20.76 [SD]; range: 7.4–103.9cm³, respectively) (P=0.01), PAFT at the esophagus (1.87mm±1.65 [SD]; range: 0.1–9.5mm vs 1.12mm±0.77 [SD]; range: 0.1–3.6mm, respectively) (P<0.001) and normalized LAV (78.3cm³/m²±48.84 [SD]; range: 32.1–319.6cm³/m² vs 42.1cm³/m²±25.43 [SD]; range: 15.7–191.4cm³/m², respectively) (P<0.001). Multiple linear regression analysis revealed that only LAV was an independent predictor (P<0.001) of persistent AF. Also PAFV was significantly associated with LAV (P=0.01).

LAV is greater in patients with AF than in control subjects and PAFV is strongly associated with LAV. PAFV and PAFT are not independently associated with AF.