Impact of cardiac computed tomography of the interatrial septum before pulmonary vein isolation

Kobza, Richard; Schoenenberger, Andreas W.; Cuculi, Florim; Zuber, Michel; Auf Der Maur, Christoph; Buhmann, Ralf; Resink, Therese J.; Erne, Paul (2013). Impact of cardiac computed tomography of the interatrial septum before pulmonary vein isolation. Pacing and clinical electrophysiology, 36(10), pp. 1245-1250. Wiley 10.1111/pace.12157

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BACKGROUND Multidetector 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 RESULTS In 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). CONCLUSIONS MDCT 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic
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UniBE Contributor:

Schoenenberger, Andreas and Cuculi, Florim

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1540-8159

Publisher:

Wiley

Language:

English

Submitter:

Rebecca Rufer

Date Deposited:

16 Jun 2014 10:52

Last Modified:

11 Nov 2015 09:34

Publisher DOI:

10.1111/pace.12157

PubMed ID:

23679889

Uncontrolled Keywords:

atrial fibrillation, patent foramen ovale, pulmonary vein isolation

BORIS DOI:

10.7892/boris.46351

URI:

https://boris.unibe.ch/id/eprint/46351

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