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Value of Multi Slice Computed Tomography in Detection of Left Atria Thrombi Before Ablation of Atria
作者:夏云龙[1] 
单位:大连医科大学附属第一医院[1]  
文章号:W013634  
2006/8/16 19:03:34    
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    Background Transesophageal Echocardiography (TEE), frequently used before ablation of atrial fibrillation, constitutes a routine to detect atrial thrombi. TEE is a safe test, but may be considered not completely non-invasive. The development of alternative imaging modalities to rule out atrial thrombi thus bears potential interest. We therefore evaluated the ability of the multi slice computed tomography (MSCT) to visualize atrial thrombi before ablation of atrial fibrillation.

    Methods 226 patients (48 female, mean age 58±11 ys.) with persistent AF on an intention to ablation basis were enrolled. To detect atrial thrombi before catheter ablation, we performed TEE, MSCT and both in 45 (Group TEE), 144 (Group MSCT) and 37 cases (Group Both), respectively. After that, the routine segmental or circumferential PV ablation was applied. The complication of stroke or TIA was observed.

    Results Atrial thrombus was detected in 5 patients from Group TEE (11.1%) and in 11 from Group MSCT (7.6%). In Group Both, atrial thrombus demonstrated by TEE, MSCT, and both in 2, 1 and 2 cases, respectively. These 21 patients were then precluded for further ablation, and anticoagulation drugs were administrated. In the rest 205 cases, ablation was routinely performed. Two patients developed into TIA during ablation procedure, though one has been demonstrated to be thrombus free in Group TEE (2.5%) and the other in Group MSCT (0.7%). In Group MSCT, another patient got stroke the day after the ablation (0.7%). 

    Conclusion Compared to TEE, MSCT showed similar sensitivity to detect the atrial thrombi in patients with AF. With more and more request of MSCT in AF patients, further studies are needed to explore whether MSCT could be a complimentary, or even an alternative diagnostic tool of choice to detect atrial thrombi before ablation.

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作者简介
夏云龙
单位:大连医科大学附属第一医院
简介:  博士,教授,博士生导师;教育部长江学者特聘教授。美国心律学学会委员(FHRS);欧洲心脏病学会委
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