title: Esophagus imaging for radiofrequency ablation of atrial fibrillation using a dual-source computed tomography system: preliminary observations.
abstract: OBJECTIVE
  The very recent introduction of dual-source computed tomography (DSCT) has significantly improved the temporal resolution of ECG-gated multidetector-row cardiac computed tomography (CT). The aim of the present study was to evaluate whether with a DSCT visualization of the esophagus is feasible without any use of contrast in the esophagus.
  
  
  METHODS
  A total of 20 patients were evaluated. Ten patients underwent examination with a DSCT scanner without a gastric tube. In another ten patients, which served as control group, a CT scan was performed with a radio-opaque gastric tube prior to circumferential pulmonary vein isolation (in seven patients with a 16-slice CT and in three patients with a DSCT).
  
  
  RESULTS
  In the control group the gastric tube and the left atrium were reconstructed and were well visualized in all ten patients in the electro-anatomic mapping system, independently whether 16-row CT or DSCT scan was used. In the study group integration of the esophagus into the electro-anatomic mapping system was not feasible, due to the lacking contrast counterpart the surrounding tissue.
  
  
  CONCLUSIONS
  Even with the newest generation of DSCT scanner it is not possible to integrate the esophagus image into the 3-D electroanatomic mapping system without contrast by whatever means. However placing a conventional gastric tube before performing the CT scan allowed visualization and integration of the esophagus into the 3-D electro-anatomical map in all patients.
authors.affiliation: Division of Cardiology, Kantonsspital Luzern, 6000, Luzern 16, Switzerland.
authors.forename: Richard
authors.initials: R
authors.lastname: Kobza
authors.forename: Christoph
authors.initials: C
authors.lastname: Auf der Maur
authors.forename: Claudia
authors.initials: C
authors.lastname: Kurtz
authors.forename: Alexander
authors.initials: A
authors.lastname: Hoffmann
authors.forename: Bernhard
authors.initials: B
authors.lastname: Allgayer
authors.forename: Paul
authors.initials: P
authors.lastname: Erne
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation; D002309:Cardiology / Q000379:methods*; D016022:Case-Control Studies; D017115:Catheter Ablation; D004594:Electrophysiology; D004947:Esophagus / Q000473:pathology*; D006321:Heart / Q000033:anatomy & histology; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D008953:Models, Anatomic; D014057:Tomography, X-Ray Computed / Q000379:methods*