Accuracy of dual-source computed tomography to identify significant coronary artery disease in patients with atrial fibrillation: comparison with coronary angiography

European Heart Journal
Mohamed MarwanStephan Achenbach

Abstract

It has been previously reported that the sensitivity and specificity of multislice computed tomography (CT) for detecting significant coronary artery disease (CAD) is high. However, regular sinus rhythm has been considered a prerequisite for an adequate examination, even though atrial fibrillation (AF) is common among patients evaluated for the presence of coronary heart disease. In this study, we investigated the sensitivity and specificity of dual-source CT (DSCT) to detect and rule out significant coronary stenoses in patients with AF referred for invasive coronary angiography. One hundred and ten consecutive patients with AF who were admitted for a first diagnostic coronary angiogram were screened for participation. Out of these, 50 patients were excluded either due to renal insufficiency, inability to maintain an adequate breath hold or due to rapid AF non-responsive to β-blocker therapy (heart rate > 100 b.p.m.). Sixty remaining patients (mean age 71 ± 7 years) were included and subjected to CT angiography using DSCT within 24 h before invasive coronary angiography. A contrast-enhanced volume data set was acquired (330 ms gantry rotation, collimation 2 × 64 × 0.6 mm, retrospective electrocardiogram gating). Data sets were...Continue Reading

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