Myocardial neuroendocrine tumour metastasis mimicking melanoma: multimodality imaging diagnosis.

Tilz RR et al. Impact of pulmonary vein anatomy assessed by cardiac magnetic resonance imaging on endo-scopic pulmonary vein isolation in consecutive patients. Impact of pharmacological autonomic blockade on complex fractionated atrial electrograms. A et al. Prospective assessment of late conduction recurrence across radiofrequency lesions producing electrical disconnection at the pulmonary vein ostium in patients with atrial fibrilla-tion. Mechanisms of recurrent atrial fibrillation after pulmonary vein isolation by segmental ostial ablation. titration strategies with the endoscopic ablation system: lessons from the high-dose vs. low-dose laser ablation study. et al. Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation: lessons learned by use of magnetic resonance imaging. et al. Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation. Relation of left atrial volume from three-dimensional computed tomography to atrial fibrillation recurrence following ablation. Does left atrial volume and pulmonary venous anatomy predict the outcome of catheter ablation of atrial fibrillation? Left atrial sphericity: a new method to assess atrial remodeling. Impact on the outcome of atrial fibrillation ablation. Structural abnormalities in atrial walls are associated with presence and persistency of atrial fibrillation but not with age.ation of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibril-lation catheter ablation: the DECAAF study. A 77-year-old woman was referred for transthor-acic echocardiogram (TTE) following episodes of paroxysmal atrial flutter. TTE showed an echogenic mass within the apical interventricular septum (Panel A, arrow). There was mild mitral and tri-cuspid regurgitation, but the valve leaflets were normal. On contrast-enhanced thoracic computed tomography (CT), the mass showed heterogeneous enhancement (Panel B, arrow). Cardiac magnetic resonance imaging (CMR) revealed that the mass was hyperintense on T1 (Panel C, arrow) and short tau inversion recovery (STIR) images (Panel D, arrow), with enhancement isointense to myocardium on late gadolinium images (Panel E, arrow). Due to the high T1 signal and patient's age, melanoma metastasis was thought to be most likely. Although typically melanin exhibits T2 hypointensity, this can be variable depending on melanin content. However, no skin lesions were present on examination. A staging abdominal CT demonstrated thickening of the terminal ileum, merging with a 20 mm spiculated mesenteric mass containing calcification (Panel F, white arrow). An Indium-111-labelled Octreotide single-photon emission CT scan (Panel G) showed radiopharma-ceutical uptake within the thickened ileum, mesenteric mass (arrow), and the septal tumour (arrowhead). Subsequent ultrasound-guided biopsy of the …