The prevalence of extracardiac findings by multidetector computed tomography before atrial fibrillation ablation.
OBJECTIVE
The study was designed to determine the prevalence of extracardiac findings discovered during multidetector computed tomography (CT) (MDCT) examinations before atrial fibrillation ablation. Multidetector CT has become a valuable tool in detailing left atrial anatomy before catheter ablation. The incidence of extracardiac findings has been reported for electron beam CT calcium scoring and coronary MDCT, but no data exist for the prevalence of extracardiac findings discovered before atrial fibrillation ablation with MDCT.


RESULTS
Clinical reports from MDCT examinations before atrial fibrillation ablation and interpretations by 2 radiologists blinded to the clinical reports were reviewed for significant additional extracardiac findings and recommendations for follow-up. In 149 patients who underwent MDCT, the mean age was 55.9 +/- 11.0 years, 75% were men, and 47% had a history of smoking. Extracardiac findings were identified in 69% of patients with clinical, 90% of reader 1, and 97% of reader 2 interpretations (kappa = 0.086). Follow-up was recommended in 30% of clinical, 50% of reader 1, and 38% of reader 2 interpretations (kappa = 0.408). Pulmonary nodules were the most common additional finding and reason for suggested follow-up for all interpreters.


CONCLUSIONS
The prevalence of extracardiac abnormalities detected by MDCT is considerable. Significant variability in their identification exists between interpreters, but there is good agreement about the need for further follow-up. It is important that those who interpret these examinations are adequately trained in the identification and interpretation of both cardiac and extracardiac findings.
Schietinger
Brian J
BJ
Department of Medicine, Cardiovascular Division, University of Virginia Health System, Charlottesville, VA 22908, USA.
Bozlar
Ugur
U
Hagspiel
Klaus D
KD
Norton
Patrick T
PT
Greenbaum
Heather R
HR
Wang
Hongkun
H
Isbell
David C
DC
Patel
Rajan A G
RA
Ferguson
John D
JD
Gay
Spencer B
SB
Kramer
Christopher M
CM
Mangrum
J Michael
JM
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000628:therapy*; D017115:Catheter Ablation; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D015995:Prevalence; D012140:Respiratory Tract Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed