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Dual-enhancement cardiac computed tomography for assessing left atrial thrombus and pulmonary veins before radiofrequency catheter ablation for atrial fibrillation

Authors
 Jin Hur  ;  Hui-Nam Pak  ;  Young Jin Kim  ;  Hye-Jeong Lee  ;  yuk-Jae Chang  ;  Yoo Jin Hong  ;  Byoung Wook Choi 
Citation
 AMERICAN JOURNAL OF CARDIOLOGY, Vol.112(2) : 238-244, 2013 
Journal Title
 AMERICAN JOURNAL OF CARDIOLOGY 
ISSN
 0002-9149 
Issue Date
2013
MeSH
Aged ; Atrial Fibrillation/diagnostic imaging* ; Atrial Fibrillation/surgery* ; Cardiac Imaging Techniques/methods* ; Catheter Ablation* ; Female ; Heart Atria/diagnostic imaging* ; Heart Diseases/diagnostic imaging* ; Humans ; Male ; Middle Aged ; Preoperative Care* ; Prospective Studies ; Pulmonary Veins/diagnostic imaging* ; Radiographic Image Enhancement* ; Thrombosis/diagnostic imaging* ; Tomography, X-Ray Computed/methods*
Keywords
Aged ; Atrial Fibrillation/diagnostic imaging* ; Atrial Fibrillation/surgery* ; Cardiac Imaging Techniques/methods* ; Catheter Ablation* ; Female ; Heart Atria/diagnostic imaging* ; Heart Diseases/diagnostic imaging* ; Humans ; Male ; Middle Aged ; Preoperative Care* ; Prospective Studies ; Pulmonary Veins/diagnostic imaging* ; Radiographic Image Enhancement* ; Thrombosis/diagnostic imaging* ; Tomography, X-Ray Computed/methods*
Abstract
Noninvasive imaging that provides anatomic information while excluding intracardiac thrombus would be of significant clinical value for patients referred for catheter ablation of atrial fibrillation (AF). This study assessed the diagnostic performance of a dual-enhancement single-phase cardiac computed tomography (CT) protocol for thrombus and circulatory stasis detection in AF patients before catheter ablation. We studied 101 consecutive symptomatic AF patients (71 men and 30 women; mean age, 61.8 years) who were scheduled to have catheter ablation. All patients had undergone pre-AF ablation CT imaging and transesophageal echocardiography on the same day. CT was performed with prospective electrocardiographic gating, and scanning began 180 seconds after the test bolus. Mean left atrial appendage (LAA)/ascending aorta Hounsfield unit (HU) ratios were measured on CT images. Among the 101 patients, 9 thrombi and 18 spontaneous echo contrasts were detected by transesophageal echocardiography. The overall sensitivity, specificity, positive predictive value, and negative predictive value of CT for the detection of thrombi in the LAA were 89%, 100%, 100%, and 99%, respectively. The mean LAA/ascending aorta HU ratios were significantly different between thrombus and circulatory stasis (0.17 vs 0.33, p = 0.002). Dual-enhancement single-scan cardiac CT is a sensitive modality for detecting and differentiating LAA thrombus and circulatory stasis.
Full Text
http://www.sciencedirect.com/science/article/pii/S000291491300814X
DOI
10.1016/j.amjcard.2013.03.018
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87114
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