Left atrial appendage filling defects identified by multidetector computed tomography in patients undergoing radiofrequency pulmonary vein antral isolation: A comparison with transesophageal echocardiography

CT Imaging to Assess the Left Atrial Appendage Anatomy: Clinical Implications

“…Overall, 223 patients were included in the study. CT identified LAA filling defects with a sensitivity, specificity, positive and negative predictive values of 93%, 85%, 31% and 99% respectively, as compared to TEE (Kim et al, 2007). These results have been recently confirmed by Martinez et al in a cohort of 402 patients (Martinez et al, 2009).…”

“…However, transesophageal echocardiography is semi-invasive. Multidetector cardiac CT is emerging as a powerful diagnostic tool to detect LAA thrombosis (Kim et al, 2007, Shapiro et al, 2007, Singh et al, 2009, Tang et al, 2008, Tani et al, 2003. Tani et al evaluated the usefulness of CT for detecting LAA thrombi in patients with chronic atrial fibrillation as compared to transesophageal echocardiography (Tani et al, 2003).…”

“…Kim et al have evaluated the accuracy of CT detect LAA filling defects in patients undergoing pulmonary vein antrum isolation (Kim et al, 2007). Overall, 223 patients were included in the study.…”

Technological Improvements in Cardiac Thrombus Diagnosis

“…CCT can be used to detect intracardiac thrombus with high diagnostic accuracy (Fig. 3) [8][9][10][11]50,51]. A recent meta-analysis demonstrated that the overall high accuracy of cardiac CT, compared with TEE, can be used to detect LA or LAA thrombus in patients with AF.…”

“…Intra-cardiac echocardiography (ICE) and TEE evolved from transthoracic echocardiography (TTE) as an approach that uses high-frequency transducers with improved spatial resolution. Cardiac computed tomography (CCT) and cardiac magnetic resonance imaging (CMRI) have also been proposed and tested as alternative imaging modalities for cardiac thrombus detection [8][9][10][11][12][13]. More recently, new imaging techniques, such as dual-energy CT (DECT), have been developed and tested to assess flow stasis and cardiac thrombi [14].…”