Impact of Cardiac Computed Tomography of the Interatrial Septum before Pulmonary Vein Isolation

被引:8
作者
Kobza, Richard [1 ]
Schoenenberger, Andreas W. [2 ,3 ]
Cuculi, Florim [1 ]
Zuber, Michel [1 ]
Maur, Christoph Auf Der [1 ]
Buhmann, Ralf [4 ]
Resink, Therese J. [5 ]
Erne, Paul [1 ]
机构
[1] Luzerner Kantonsspital, Div Cardiol, CH-6000 Luzern 16, Switzerland
[2] Univ Hosp Bern, Dept Gen Internal Med, Inselspital, Div Geriatr, CH-3010 Bern, Switzerland
[3] Univ Bern, Bern, Switzerland
[4] Luzerner Kantonsspital, Inst Radiol, CH-6000 Luzern 16, Switzerland
[5] Univ Basel Hosp, Dept Biomed, CH-4031 Basel, Switzerland
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2013年 / 36卷 / 10期
关键词
atrial fibrillation; patent foramen ovale; pulmonary vein isolation; PATENT FORAMEN OVALE; ATRIAL-FIBRILLATION; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; ABLATION; CT; DIAGNOSIS;
D O I
10.1111/pace.12157
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundMultidetector computed tomography (MDCT) may be useful to identify patients with patent foramen ovale (PFO). The aim of this study was to analyze whether a MDCT performed before pulmonary vein isolation reliably detects a PFO that may be used for access to the left atrium. Methods and ResultsIn 79 consecutive patients, who were referred for catheter ablation of symptomatic paroxysmal or persistent atrial fibrillation (AF), the presence of a PFO was explored by MDCT and transesophageal echocardiography (TEE). TEE was considered as the gold standard, and quality of TEE was good in all patients. In 16 patients (20.3%), MDCT could not be used for analysis because of artifacts, mainly because of AF. On TEE, a PFO was found in 15 (23.8%) of the 63 patients with usable MDCT. MDCT detected six PFO of which four were present on TEE. This corresponded to a sensitivity of 26.7%, a specificity of 95.8%, a negative predictive value of 80.7%, and a positive predictive value of 66.7%. The receiver operating characteristics curve of MDCT for the detection of PFO was 0.613 (95% confidence interval 0.493-0.732). ConclusionsMDCT may detect a PFO before pulmonary isolation. However, presence of AF may lead to artifacts on MDCT impeding a meaningful analysis. Furthermore, in this study sensitivity and positive predictive value of MDCT were low and therefore MDCT was not a reliable screening tool for detection of PFO.
引用
收藏
页码:1245 / 1250
页数:6
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