Multidetector row computed tomography for identification of left atrial appendage filling defects in patients undergoing pulmonary vein isolation for treatment of atrial fibrillation: Comparison with transesophageal echocardiography

Heart Rhythm ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 253-260 ◽  
Author(s):  
Apoor Patel ◽  
Eric Au ◽  
Kerry Donegan ◽  
Robert J. Kim ◽  
Fay Y. Lin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Multidetector Row Computed Tomography ◽  
Multidetector Row

scholarly journals Exclusion of Left Atrial Appendage Thrombus Using Single Phase Coronary Computed Tomography as Compared to Transesophageal Echocardiography in Patients Undergoing Pulmonary Vein Isolation

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Jason Saucedo ◽  
Shaun Martinho ◽  
Dianne Frankel ◽  
Ahmad M. Slim ◽  
Robert E. Eckart
Keyword(s):  
Computed Tomography ◽  
Transesophageal Echocardiography ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Predictive Value ◽  
Left Atrial ◽  
Single Phase ◽  
Left Atrial Appendage ◽  
Filling Defect ◽  
Atrial Appendage

Background. Transesophageal echocardiography (TEE) is used for the evaluation of the presence of left atrial appendage (LAA) thrombus prior to pulmonary vein isolation (PVI), while coronary computed tomography angiography (CCTA) is used for anatomic mapping during PVI. Methods. We compared the diagnostic performance of single phase CCTA to TEE in excluding the presence of LAA thrombus in patients undergoing PVI in 172 subjects performed during index hospitalization. Results. The mean age was 51±13 years, a median CHADS2 score of 1 [IQR25,75 0,1, range 0–3] and a mean periprocedural INR of 2.1±0.6. The prevalence of an LAA filling defect on single phase CCTA was 9.3% (6/183) and on TEE was 1.2% (2/183). Sensitivity, specificity, positive predictive value, and negative predictive value were 100% (95% CI, 19.8–100%), 91.8% (95% CI, 94–99%), 12.5% (95% CI, 60–76%), and 91.8% (95% CI, 97–100%) for the detection of LAA filling defect, respectively. Conclusion. Given the utility of a preprocedural single phase CCTA for the performance of PVI, the absence of a filling defect negates the need for a subsequent TEE as an adjunct for exclusion of LAA thrombus.

scholarly journals B-PO02-074 LEFT ATRIAL APPENDAGE CLOSURE IMPACT ON ATRIAL FIBRILLATION RECURRENCE-RATE IN PATIENTS UNDERGOING PULMONARY VEIN ISOLATION

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S126
Author(s):  
Ciro Ascione ◽  
Marco Bergonti ◽  
Valentina Catto, Stefania I. Riva ◽  
Massimo Moltrasio ◽  
Fabrizio Tundo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Recurrence Rate ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Atrial Fibrillation Recurrence ◽  
Left Atrial Appendage Closure

Prevalence and Clinical Determinants of Left Atrial Appendage Thrombus in Patients With Atrial Fibrillation Before Pulmonary Vein Isolation

2015 ◽  
Vol 116 (9) ◽  
pp. 1368-1373 ◽  
Author(s):  
Makiko Nishikii-Tachibana ◽  
Nobuyuki Murakoshi ◽  
Yoshihiro Seo ◽  
DongZhu Xu ◽  
Masayoshi Yamamoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Thrombus

scholarly journals Transition from Transesophageal Echocardiography to Cardiac Computed Tomography for the Evaluation of Left Atrial Appendage Thrombus Prior to Atrial Fibrillation Ablation and Incidence of Cerebrovascular Events During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Tauseef Akhtar ◽  
Ryan Wallace ◽  
Usama Daimee ◽  
Erica Hart ◽  
Armin Arbab-Zadeh ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Cardiac Computed Tomography ◽  
Ct Imaging ◽  
Atrial Appendage ◽  
Af Ablation ◽  
Cerebrovascular Events

Background Transesophageal echocardiography (TEE) is variably performed before atrial fibrillation (AF) ablation to evaluate left atrial appendage (LAA) thrombus. We describe our experience with transitioning to the pre-ablation cardiac computed tomography (CT) approach for the assessment of LAA thrombus during the COVID-19 pandemic. Methods We studied consecutive patients undergoing AF ablation at our center. The study cohort was divided into pre- vs. post-COVID groups. The pre-COVID cohort included ablations performed during 1 year before the COVID-19 pandemic; pre-ablation TEE was used routinely to evaluate LAA thrombus in high-risk patients. Post-COVID cohort included ablations performed during the 1 year after the COVID-19 pandemic; pre-ablation CT was performed in all patients, with TEE performed only in patients with LAA thrombus by CT imaging. The demographics, clinical history, imaging, and ablation characteristics, and peri-procedural cerebrovascular events (CVE) were recorded. Results A total of 637 patients (pre-COVID n=424, post-COVID n=213) were studied. The mean age was 65.6  10.1 years in the total cohort, and the majority were men. There was a significant increase in pre-ablation CT imaging from pre to post-COVID cohort (74.8 vs. 93.9%, p=<0.01), with a significant reduction in TEEs (34.6 vs. 3.7%, p=<0.01). One patient in the post-COVID cohort developed CVE following negative pre-ablation CT. However, the incidence of peri-procedural CVE between both cohorts remained statistically unchanged (0 vs. 0.4%, p=0.33). Conclusion Implementation of pre ablation CT-only imaging strategy with selective use of TEE for LAA thrombus evaluation is not associated with increased CVE risk during the COVID- 19 pandemic.

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