Abstract
To evaluate predictor variables and accuracy of left atrial appendage (LAA) filling defects seen on multidetector computed tomographic (MDCT) scan in predicting LAA thrombus in patients undergoing pulmonary vein (PV) isolation procedure. Electrocardiogram-gated 64-slice MDCT and transesophageal echocardiography (TEE) were undertaken in 51 consecutive patients with nonvalvular atrial fibrillation who were referred for circumferential antral pulmonary vein isolation. In 51 patients (37 men; mean age, 64 years), left atrium (LA) diameter emerged as the predictor of LAA filling defects (odds ratio, 4.9; 95% confidence interval, 1.19-20.25). Left atrial appendage filling defects had sensitivity of 100%, specificity of 95.92%, positive predictive value of 0.5, and negative predictive value of 1, for thrombi seen on TEE image. A mean LAA/ascending aorta Hounsfield unit ratio of 0.78 or less was identified as a sensitive predictor of thrombus on TEE (sensitivity, 100%; specificity, 87.8%; positive predictive value, 0.25; and negative predictive value, 1). A larger LA predisposes to LAA filling defects on MDCT scan. Pending prospective validation, absence of LAA filling defects on 64-slice MDCT may reliably exclude LAA thrombi in patien...Continue Reading
References
Jan 1, 1991·Circulation·A MüggeP R Lichtlen
Jun 1, 1988·Journal of the American College of Cardiology·W G DanielP R Lichtlen
Jan 1, 1993·Journal of Computer Assisted Tomography·T NakanishiS Nagata
Dec 10, 1999·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·R W AsingerJ L Halperin
Jan 25, 2003·Journal of Computer Assisted Tomography·Tomomitsu TaniMakoto Itoh
Feb 20, 2003·Circulation·Thorsten DillHeinz-F Pitschner
Apr 23, 2003·Journal of the American College of Cardiology·David SchwartzmanWilliam G Wigginton
Feb 19, 2004·The American Journal of Cardiology·Wael A JaberCraig R Asher
Aug 16, 2006·Circulation·Valentin FusterUNKNOWN Heart Rhythm Society
Oct 3, 2006·Journal of the American College of Cardiology·Robert C HendelUNKNOWN Society of Interventional Radiology
Nov 24, 2007·American Heart Journal·Yuli Y KimMilind Y Desai
Nov 29, 2007·Journal of Computer Assisted Tomography·Michael D ShapiroRicardo C Cury
Feb 5, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Apoor PatelBruce B Lerman
Feb 16, 2008·Heart·Antonio Colombo, Azeem Latib
Feb 28, 2008·Journal of Cardiovascular Electrophysiology·Ilan GottliebCharles A Henrikson
Citations
Sep 3, 2010·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Suraj KapaPeter A Brady
Jul 19, 2012·Journal of Computer Assisted Tomography·Mitsutomi IshiyamaYukihisa Saida
Oct 1, 2015·The International Journal of Cardiovascular Imaging·Olga LazouraEdward Nicol
Mar 21, 2017·Radiology·Jin Hur, Byoung Wook Choi
Feb 15, 2013·Circulation. Cardiovascular Imaging·Jorge RomeroMario J Garcia
Jan 1, 2012·Journal of Medical Ultrasonics·Kazuko YoshimotoAtsushi Ueki
Jul 28, 2018·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Marc KottmaierIsabel Deisenhofer
Aug 31, 2012·Internal Medicine Journal·Z NingB-L Hu
Jul 17, 2019·International Heart Journal·Keiichiro KuronumaYasuo Okumura
Jul 17, 2015·Internal Medicine Journal·H ZouZ Liu
Mar 6, 2021·European Journal of Radiology Open·Narumol Chaosuwannakit, Pattarapong Makarawate