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

Hye Jeong Lee, Youngjin Kim, Jin Hur, Ji Eun Nam, Yoo Jin Hong, Hee Yeong Kim, Hua Sun Kim, Kyu Ok Choe, Byoung Wook Choi

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)536-540
Number of pages5
JournalAmerican Journal of Cardiology
Volume108
Issue number4
DOIs
Publication statusPublished - 2011 Aug 15

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Catheter Ablation
Pulmonary Veins
Heart Atria
Atrial Fibrillation
Electrocardiography
Tomography
Anatomy
Contrast Media
Kidney
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, Hye Jeong ; Kim, Youngjin ; Hur, Jin ; Nam, Ji Eun ; Hong, Yoo Jin ; Kim, Hee Yeong ; Kim, Hua Sun ; Choe, Kyu Ok ; Choi, Byoung Wook. / Low-dose electrocardiography synchronized nonenhanced computed tomography for assessing left atrium and pulmonary veins before radiofrequency catheter ablation for atrial fibrillation. In: American Journal of Cardiology. 2011 ; Vol. 108, No. 4. pp. 536-540.
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abstract = "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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Low-dose electrocardiography synchronized nonenhanced computed tomography for assessing left atrium and pulmonary veins before radiofrequency catheter ablation for atrial fibrillation. / Lee, Hye Jeong; Kim, Youngjin; Hur, Jin; Nam, Ji Eun; Hong, Yoo Jin; Kim, Hee Yeong; Kim, Hua Sun; Choe, Kyu Ok; Choi, Byoung Wook.

In: American Journal of Cardiology, Vol. 108, No. 4, 15.08.2011, p. 536-540.

Research output: Contribution to journalArticle

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