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

scholarly journals Accuracy of Commonly-Used Imaging Modalities in Assessing Left Atrial Appendage for Interventional Closure: Review Article

2018 ◽  
Vol 7 (11) ◽  
pp. 441 ◽  
Author(s):  
Ramez Morcos ◽  
Haider Al Taii ◽  
Priya Bansal ◽  
Joel Casale ◽  
Rupesh Manam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Imaging Modality ◽  
Three Dimensional ◽  
Atrial Appendage ◽  
Imaging Modalities ◽  
Three Dimensional Printing ◽  
Dimensional Printing

Periprocedural imaging assessment for percutaneous Left Atrial Appendage (LAA) transcatheter occlusion can be obtained by utilizing different imaging modalities including fluoroscopy, magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound imaging. Given the complex and variable morphology of the left atrial appendage, it is crucial to obtain the most accurate LAA dimensions to prevent intra-procedural device changes, recapture maneuvers, and prolonged procedure time. We therefore sought to examine the accuracy of the most commonly utilized imaging modalities in LAA occlusion. Institutional Review Board (IRB) approval was waived as we only reviewed published data. By utilizing PUBMED which is an integrated online website to list the published literature based on its relevance, we retrieved thirty-two articles on the accuracy of most commonly used imaging modalities for pre-procedural assessment of the left atrial appendage morphology, namely, two-dimensional transesophageal echocardiography, three-dimensional transesophageal echocardiography, computed tomography, and three-dimensional printing. There is strong evidence that real-time three-dimensional transesophageal echocardiography is more accurate than two-dimensional transesophageal echocardiography. Three-dimensional computed tomography has recently emerged as an imaging modality and it showed exceptional accuracy when merged with three-dimensional printing technology. However, real time three-dimensional transesophageal echocardiography may be considered the preferred imaging modality as it can provide accurate measurements without requiring radiation exposure or contrast administration. We will present the most common imaging modality used for LAA assessment and will provide an algorithmic approach including preprocedural, periprocedural, intraprocedural, and postprocedural.

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