Transoesophageal echocardiography prior to catheter ablation could be avoided in atrial fibrillation patients with a low risk of stroke and without filling defects in the late-phase MDCT scan: A retrospective analysis of 783 patients

Zhai, Zhengqin; Tang, Min; Zhang, Shu; Fang, Pihua; Jia, Yuhe; Feng, Tianjie; Wang, Jiande

doi:10.1007/s00330-017-5172-6

Cited by 15 publications

(22 citation statements)

References 29 publications

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“…The baseline characteristics of the included studies are shown in Table 1 . 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 Seventeen studies (63%) had a prospective design, and 10 studies (37%) had a retrospective design. Nineteen studies (70%) were performed with patients scheduled for pulmonary vein isolation (PVI), 4 studies (15%) were performed with patients recently experiencing stroke, 1 study was performed with patients scheduled to direct current cardioversion, and the remaining 3 studies had mixed populations.…”

Section: Resultsmentioning

confidence: 99%

Cardiac Computed Tomography Versus Transesophageal Echocardiography for the Detection of Left Atrial Appendage Thrombus: A Systemic Review and Meta‐Analysis

Zhang

2021

JAHA

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Background Transesophageal echocardiography (TEE) has been considered the gold standard for left atrial appendage (LAA) thrombus detection. Nevertheless, TEE may sometimes induce discomfort and cause complications. Cardiac computed tomography has been studied extensively for LAA thrombus detection. We performed this systemic review and meta‐analysis to assess the diagnostic accuracy of cardiac computed tomography for LAA thrombus detection compared with TEE. Methods and Results A systemic search was conducted in the PubMed, Embase, and Cochrane Library databases from January 1977 to February 2021. Studies performed for assessment diagnostic accuracy of cardiac computed tomography on LAA thrombus compared with TEE were included. Summary sensitivity, specificity, and posterior probability of LAA thrombus was calculated by using bivariate random‐effects model. The Quality Assessment of Diagnostic Accuracy Studies‐2 tool was used for the quality assessment. A total of 27 studies involving 6960 patients were included in our study. The summary sensitivity of early imaging studies was 0.95 (95% CI, 0.79–0.99), and the specificity was 0.89 (95% CI, 0.85–0.92). The positive posterior probability was 19.11%, and the negative posterior probability was 0.16%. The summary sensitivity of delayed imaging studies was 0.98 (95% CI, 0.92–1.00), and the specificity was 1.00 (95% CI, 0.98–1.00). The positive posterior probability was 95.76%, and the negative posterior probability was 0.12%. The delayed imaging method significantly improved the specificity (1.00 versus 0.89; P <0.05) and positive posterior probability (95.76% versus 19.11%; P <0.05). Conclusions Cardiac computed tomography with a delayed imaging is a reliable alternative to TEE. It may save the patient and health care from an excess TEE. Registration URL: https://www.crd.york.ac.uk/PROSPERO ; Unique identifier: CRD42021236352.

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Section: Resultsmentioning

confidence: 99%

Cardiac Computed Tomography Versus Transesophageal Echocardiography for the Detection of Left Atrial Appendage Thrombus: A Systemic Review and Meta‐Analysis

Zhang

2021

JAHA

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“…Исследование Z. Zhai и соавт. показало, что отсутствие дефекта наполнения в поздней фазе мультиспиральной КТ позволяет исключить наличие тромба УЛП и избежать ЧпЭхоКГ перед катетерной абляцией у пациентов с ФП с низким риском инсульта (балл по шкале CHA2DS2-VASc ≤3) [14].…”

Section: принятые сокращенияunclassified

Possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation

Galyautdinov

Ibragimova²,

Galeeva

2023

Kazan Med J

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Computed and magnetic resonance imaging of the heart has been widely used in recent years in patients with atrial fibrillation. They are used to determine the morphology of the heart, the presence of intracardiac thrombi, quantify the structures of the heart, thrombosis of intracardiac devices, determine tactics for surgical interventions, and other purposes. These methods of instrumental diagnostics can be used as an alternative to transesophageal echocardiography, which has a number of limitations and disadvantages compared to computed tomography and magnetic resonance imaging. Computed and magnetic resonance imaging of the heart are used to avoid invasiveness in the study of the heart, to improve the accuracy of measuring heart structures, to reduce the number of diagnostic methods used before various surgical interventions in patients with atrial fibrillation, and also, according to epidemic indications, as part of the prevention of the spread of coronavirus infection. In addition, magnetic resonance imaging allows to avoid radiation exposure to the patient. The review presents the results of studies, meta-analyses of pooled samples, as well as a description of the clinical possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation. Publications on the use of these methods for visualization of thrombi in the left atrium and its appendage, in pulmonary vein ablation and occlusion of the left atrial appendage, as well as data on visualization of the residual flow around the occlusive device and thrombosis of intracardiac devices are presented. According to the results of a literature review, computed tomography and magnetic resonance imaging of the heart have similar or higher imaging capabilities compared to transesophageal echocardiography, as well as some advantages over it, primarily the non-invasiveness of the procedure. The works demonstrating the possibilities of computed tomography of the heart for the diagnosis of coronary heart disease in patients with atrial fibrillation are presented. In preparing the review, the literature search method in PubMed databases for the period 20132022 was used.

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“…The result shows that a delayed imaging method of cardiac CT significantly improved the specificity (1.00 vs. 0.89; P <0.05) and positive posterior probability (95.76% vs. 19.11%; P <0.05) compared with TEE and may save the patients from an excess TEE. Also, preprocedural TEE can be avoided for patients with AF, who have a low risk of stroke and no filling defect on delayed CT scans 93. In addition, for the recently developed TAVR, multislice CT can detect the geometry of the implanted valve stent and potentially optimize size selection during TAVR 94.…”

Section: Imaging In Structural Heart Diseasementioning

confidence: 99%

The Chinese Experience of Imaging in Cardiac Intervention

Liu

Yang

Chen

2022

Journal of Thoracic Imaging

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Recent scientific and technological advances have greatly contributed to the development of medical imaging that could enable specific functions. It has become the primary focus of cardiac intervention in preoperative assessment, intraoperative guidance, and postoperative follow-up. This review provides a contemporary overview of the Chinese experience of imaging in cardiac intervention in recent years.

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Transoesophageal echocardiography prior to catheter ablation could be avoided in atrial fibrillation patients with a low risk of stroke and without filling defects in the late-phase MDCT scan: A retrospective analysis of 783 patients

Abstract: • MDCT can help detect the presence of LAA thrombus. • TEE can be avoided when late-phase MDCT shows no filling defect. • TEE is required in patients whose MDCT images indicate thrombus.

Cited by 15 publications

References 29 publications

Cardiac Computed Tomography Versus Transesophageal Echocardiography for the Detection of Left Atrial Appendage Thrombus: A Systemic Review and Meta‐Analysis

Cardiac Computed Tomography Versus Transesophageal Echocardiography for the Detection of Left Atrial Appendage Thrombus: A Systemic Review and Meta‐Analysis

Possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation

The Chinese Experience of Imaging in Cardiac Intervention

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Transoesophageal echocardiography prior to catheter ablation could be avoided in atrial fibrillation patients with a low risk of stroke and without filling defects in the late-phase MDCT scan: A retrospective analysis of 783 patients

Abstract: • MDCT can help detect the presence of LAA thrombus. • TEE can be avoided when late-phase MDCT shows no filling defect. • TEE is required in patients whose MDCT images indicate thrombus.

Cited by 15 publications

References 29 publications

Cardiac Computed Tomography Versus Transesophageal Echocardiography for the Detection of Left Atrial Appendage Thrombus: A Systemic Review and Meta‐Analysis

Cardiac Computed Tomography Versus Transesophageal Echocardiography for the Detection of Left Atrial Appendage Thrombus: A Systemic Review and Meta‐Analysis

Possibilities of computed and magnetic resonance imaging of the heart in patients with ­atrial fibrillation

The Chinese Experience of Imaging in Cardiac Intervention

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Resources

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Possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation