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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.
MedLine Citation:
PMID:  21624544     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Hye-Jeong Lee; Young Jin Kim; Jin Hur; Ji Eun Nam; Yoo Jin Hong; Hee Yeong Kim; Hua Sun Kim; Kyu Ok Choe; Byoung Wook Choi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-28
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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