Document Detail


Value of multislice computed tomography angiography of the thorax in preparation for catheter ablation for the treatment of atrial fibrillation: the impact of unexpected cardiac and extracardiac findings on patient care.
MedLine Citation:
PMID:  18703300     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In patients referred for catheter ablation for the treatment of atrial fibrillation, multislice computed tomography angiography of the thorax is routinely performed to assess pulmonary vein anatomy. We sought to investigate the incidence of unexpected cardiac and extracardiac findings in this select patient population and to establish how these findings influence subsequent patient care. METHODS: Ninety-five patients (mean age 62+/-10 years, 35% female) referred to our institution for ablation therapy for atrial fibrillation between July 2003 and October 2007 underwent multislice computed tomography angiography of the thorax. Radiologists interpreted all images. Need for additional testing, consultation and eventual diagnosis were assessed by electronic record review. RESULTS: A total of 83 (5 cardiac, 78 extracardiac) unexpected findings were observed in 50/95 (53%) of patients. The findings prompted 23 additional tests (5 cardiac, 18 noncardiac) in 15/95 (16%) of patients and 8 subsequent referrals in 7/95 (7%) patients. In 6 patients the findings significantly altered future patient care and resulted in postponement of ablation therapy in 4 patients. In 2 patients, extracardiac findings (pulmonary emboli and adenocarcinoma of the lung) were of potentially life-saving consequence. CONCLUSIONS: In patients undergoing multislice computed tomography angiography of the thorax in anticipation of planned catheter ablation therapy for the treatment of atrial fibrillation, unexpected findings are common and of potentially significant value. In comparison, there is a higher prevalence of unexpected extracardiac, rather than cardiac findings. Further investigation of these findings may lead to postponement of ablation therapy, but may also be of potentially lifesaving consequence.
Authors:
Erik Wissner; Clinton V Wellnitz; Komandoor Srivathsan; Luis R Scott; Gregory T Altemose
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-08-13
Journal Detail:
Title:  European journal of radiology     Volume:  72     ISSN:  1872-7727     ISO Abbreviation:  Eur J Radiol     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-17     Completed Date:  2010-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  284-8     Citation Subset:  IM    
Affiliation:
Mayo Clinic Arizona-Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.
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MeSH Terms
Descriptor/Qualifier:
Arizona / epidemiology
Atrial Fibrillation / epidemiology,  radiography*,  surgery*
Catheter Ablation / statistics & numerical data*
Coronary Angiography / statistics & numerical data*
Female
Humans
Incidence
Male
Middle Aged
Radiography, Thoracic / statistics & numerical data*
Tomography, X-Ray Computed / statistics & numerical data*
Treatment Outcome

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