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Low-dose electrocardiography synchronized nonenhanced computed tomography for assessing left atrium and pulmonary veins before radiofrequency catheter ablation for atrial fibrillation.

 Hye-Jeong Lee  ;  Young Jin Kim  ;  Byoung Wook Choi  ;  Kyu Ok Choe  ;  Hua Sun Kim  ;  Hee Yeong Kim  ;  Yoo Jin Hong  ;  Ji Eun Nam  ;  Jin Hur 
 American Journal of Cardiology, Vol.108(4) : 536-540, 2011 
Journal Title
 American Journal of Cardiology 
Issue Date
Recently contrast-enhanced cardiac computed tomography (CT) was found to be useful for imaging the left atrium and pulmonary veins (PVs) before radiofrequency catheter ablation in patients with atrial fibrillation. However, the risks of contrast agent in patients with impaired renal function must be considered. We investigated the accuracy of low-dose electrocardiographically synchronized nonenhanced cardiac CT (NECT) for identifying PV anatomy. One hundred eight consecutive patients who underwent cardiac CT before radiofrequency catheter ablation of atrial fibrillation were included. Nonenhanced cardiac computed tomogram was retrospectively evaluated for each patient by 2 radiologists for the following PV anatomy: conventional pattern, conjoined ostium, and accessory PVs with number and location. Sensitivity and specificity for variations in PVs were calculated using contrast-enhanced cardiac computed tomogram as the reference standard. Detection rates for each variation were also calculated. Twenty-one right PV (RPV) variations and 11 left PV (LPV) variations were observed. NECT showed a high diagnostic performance in detecting variations in PVs for the 2 observers. For RPV variations overall sensitivity was 97.6% and specificity was 96.6%. For LPV variations overall sensitivity was 90.9% and specificity was 97.9%. Overall detection rates for variation between the 2 observers were 97.1% for accessory RPV from the right middle lobe, 100% for 4 ostia with accessory RPV from the right middle lobe and accessory RPV from the superior segment of the right lower lobe, 100% for accessory RPV from the superior segment of the right lower lobe, 88.9% for conjoined ostium of the LPV, and 100% for accessory LPV from the left lingular segment. In conclusion, variations in PV anatomy were detected with great accuracy by NECT.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김영진(Kim, Young Jin) ; 김화선(Kim, Hua Sun) ; 김희영(Kim, Hee Yeong) ; 남지은(Nam, Ji Eun) ; 이혜정(Lee, Hye Jeong) ; 최규옥(Choe, Kyu Ok) ; 최병욱(Choi, Byoung Wook) ; 허진(Hur, Jin) ; 홍유진(Hong, Yoo Jin)
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