Is cardiovascular MRI equally effective as TEE in evaluation of left atrial appendage thrombus in patients with atrial fibrillation undergoing pulmonary vein isolation
نویسندگان
چکیده
Introduction Patients with atrial fibrillation (Afib) routinely undergo a transesophageal echocardiogram (TEE) for evaluation of the left atrial appendage (LAA) to rule out thrombus prior to undergoing cardioversion or pulmonary vein isolation (PVI). Cardiac MRI (CMR) is now increasingly used for evaluation of these patients for defining pulmonary vein anatomy prior to PVI. We hypothesized that 2D and 3D non-contrast and contrast CMR is as effective as TEE in evaluating for LAA thrombus while providing simultaneous comprehensive non-invasive evaluation of the pulmonary vein anatomy within a single exam.
منابع مشابه
Detection of left atrial appendage thrombus by cardiac computed tomography: a word of caution.
In this issue of iJACC, Martinez et al. (1) report their experience with cardiac computed tomography (CCT) to detect left atrial appendage thrombi in patients with atrial fibrillation undergoing pulmonary vein radiofrequency ablation. Atrial fibrillation is one of the most common cardiovascular disorders, carrying significant morbidity, including cardio-embolic stroke and heart failure. Slow fl...
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A trial fibrillation is the most common sustained arrhythmia worldwide (1), and catheter-based pulmonary vein isolation (PVI) is becoming a dominant approach to its management. Stroke and transient ischemic attack are known risks of PVI (2). To improve PVI safety, atrial thrombus needs to be excluded. Traditionally, patients undergo elective computed tomography angiography or magnetic resonance...
متن کاملExclusion of Left Atrial Appendage Thrombus Using Single Phase Coronary Computed Tomography as Compared to Transesophageal Echocardiography in Patients Undergoing Pulmonary Vein Isolation
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 patien...
متن کاملComparison of magnetic resonance imaging and transesophageal echocardiography in detection of thrombus in the left atrial appendage.
BACKGROUND AND PURPOSE A noninvasive technique of visualizing the left atrial appendage (LAA) and its thrombus in patients with atrial fibrillation would be of great interest. This study examined the utility of MRI for the assessment of thrombus in the LAA. METHODS We evaluated 50 subjects with nonrheumatic continuous atrial fibrillation and a history of cardioembolic stroke. Each patient rec...
متن کاملRole of the CHADS2 score in the evaluation of thromboembolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation.
OBJECTIVES The goals of this study were to determine: 1) if low-risk patients assessed by a CHADS(2) score, a clinical scoring system quantifying a risk of stroke in patients with atrial fibrillation (AF), require a routine screening transesophageal echocardiogram (TEE) before pulmonary vein isolation (PVI); and 2) the relationship of a CHADS(2) score with left atrial (LA)/left atrial appendage...
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