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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.

Abstract：

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.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Wissner E,Wellnitz CV,Srivathsan K,Scott LR,Altemose GT

doi

10.1016/j.ejrad.2008.07.004

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

284-8

issue

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(08)00384-7

journal_volume

pub_type

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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.