2022
DOI: 10.1016/j.ijcha.2021.100939
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Major incidental findings on routine cardiovascular magnetic resonance imaging prior to first-time catheter ablation of atrial fibrillation

Abstract: Introduction Preprocedural cardiovascular magnetic resonance (CMR) or computed tomography (CT) imaging of the left atrium/pulmonary veins is usually employed to guide catheter ablation of atrial fibrillation (AFCA). Incidental findings (IFs) are common on cardiac imaging prior to AFCA. However, previous studies have mainly focused on extracardiac IFs detected on CT scan. We aimed to assess the prevalence of relevant cardiac and extracardiac IFs on routine preprocedural CMR in a large patient cohor… Show more

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Cited by 3 publications
(3 citation statements)
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“…Unexpected relevant findings on CT/CMR during pre-procedural screening affect clinical management and decision-making. Ebert et al [24] described extracardiac abnormalities in 1.5% of CT/CMR performed in the context of preprocedural screening for AF catheter ablation. Preprocedural imaging allows us to define prognostic factors; in particular, the left atrium volume, in addition to its importance as an exclusion criterion, is also a reliable risk factor for recurrence [25].…”
Section: Preprocedural Screeningmentioning
confidence: 99%
“…Unexpected relevant findings on CT/CMR during pre-procedural screening affect clinical management and decision-making. Ebert et al [24] described extracardiac abnormalities in 1.5% of CT/CMR performed in the context of preprocedural screening for AF catheter ablation. Preprocedural imaging allows us to define prognostic factors; in particular, the left atrium volume, in addition to its importance as an exclusion criterion, is also a reliable risk factor for recurrence [25].…”
Section: Preprocedural Screeningmentioning
confidence: 99%
“…detection bias), although again our data and study design were unable to examine a causal relationship. There are several potential mechanisms, including radiation exposure during AF ablation (which was, however, not supported by a further investigation 57 ), anticoagulant-related bleeding leading to early diagnosis of cancer, 58–61 incidental imaging findings for AF ablation, 62 , 63 and potential cancer risk carried by some medications used for AF. 64 A recent Mendelian randomization study did not support a causal role of AF in increasing cancer risk.…”
Section: Discussionmentioning
confidence: 93%
“…A recent study of 2000 patients who underwent CMR imaging before radiofrequency ablation for atrial fibrillation found significant incidental findings in 8.6% of patients. 25 Following clinical assessment, 42% of these patients did not undergo ablation. A substudy of the SCOT‐HEART (Scottish Computed Tomography of the Heart) trial, in which >4000 patients underwent CT coronary angiography, identified 10% of patients with clinically significant noncardiac findings, and in 3% of cases, these findings were the underlying cause of the patient's symptoms.…”
Section: Discussionmentioning
confidence: 99%