Original investigationPreablation Assessment for the Left Atrium: Comparison of ECG-gated Cardiac CT with Echocardiography
Section snippets
Materials and methods
After appropriate institutional review board approval, a retrospective review of patients who underwent atrial fibrillation ablation over an approximately 24-month period between early 2004 and 2006 at a tertiary care center was performed. Of the 122 patients who underwent EPS treatment, 34 patients who had both echocardiography and ECG-gated cardiac MSCT angiography before EPS were included. Most patients received full anticoagulation therapy before their clinical workup. Results from TTE,
Results
Over a 2-year period, 34 consecutive patients met inclusion criteria and underwent both cardiac MSCT angiography and echocardiography before EPS studies for uncontrolled atrial fibrillation. Patients included 22 males (65%) and 12 females (35%) with a mean age of 59 years (range 45–77). Documented results of TTE in the electronic records were available for all 34 patients, whereas TEE results were available for 16 patients.
The overall agreement in excluding left atrial thrombus between MSCT and
Discussion
Most patients undergoing EPS evaluation for uncontrolled atrial fibrillation have preprocedural testing to assess for left atrial thrombus and pulmonary venous anatomy. The presence of thrombus in the left atrial appendage increases the risk of systemic emboli (14, 19), which may be precipitated by manipulation of the atrium during EPS evaluation. Likewise, anatomic detail of the configuration and origins of the pulmonary veins may help direct catheter-based EPS treatments. Over the last 2
References (36)
- et al.
Evaluation of intracardiac thrombus with computed tomography
Am J Cardiol
(1983) - et al.
Value of cardiac ultrafast computed tomography for detecting right atrial thrombi in chronic atrial fibrillation
Am J Cardiol
(1997) - et al.
CT diagnosis of left atrial thrombus undiagnosed by echocardiography
Comp Radiol
(1984) - et al.
Efficacy of anticoagulation in resolving left atrial and left atrial appendage thrombi a transesophageal echocardiographic study
Am Heart J
(2000) - et al.
Echocardiographic assessment of the left atrial appendage
J Am Coll Cardiol
(1999) - et al.
Transthoracic echocardiographic predictors of left atrial appendage thrombus
Am J Cardiol
(2006) - et al.
Comparison of ability to identify left atrial thrombus by three-dimensional tomography versus transesophageal echocardiography in patients with atrial fibrillation
Am J Cardiol
(2004) - et al.
Thoracic venous anatomy multidetector row CT evaluation
Radiol Clin North Am
(2003) - et al.
Eletroanatomic reconstruction of the left atrium, pulmonary veins, and esophagus compared with the “true anatomy” on multislice computed tomography in patients undergoing catheter ablation of atrial fibrillation
Heart Rhythm
(2006) - et al.
Comparison of two-dimensional echocardiography and ultrafast cardiac computed tomography for evaluating intracardiac thrombi in cerebral ischemia
Stroke
(1990)