title: Comparison of end-diastolic versus end-systolic cardiac-computed tomography reconstruction interval in patient's prior to pulmonary vein isolation.
abstract: OBJECTIVE
  Aim of the study was to investigate diagnostic accuracy of cardiac computed tomography angiography (CCTA) between left ventricular end-systolic (LVES) and left ventricular end-diastolic (LVED) cardiac phase for thrombus detection in patient's prior to pulmonary vein isolation (PVI).
  
  
  METHODS
  182 consecutive Patients with drug refractory AF scheduled for PVI (62.6% male, mean age 64.1 ± 10.2 years) underwent routine pre-procedural evaluation including transesophageal echocardiography (TEE) and CCTA for evaluation of left atrial (LA)/left atrial appendage (LAA) anatomy and thrombus formation. Qualitative and quantitative analysis (using aorta ascendens (AA)/LAA ratio) was performed. Measurements of the LA/LAA in LVES and LVED cardiac phase were obtained.
  
  
  RESULTS
  End-systolic volumes (LA/LAA) measured in 30 patients without filling defects as control group and all 14 with filling defects of 182 patients were significantly larger (p < 0.01) than in end-diastolic phase. Qualitative analysis was inferior to quantitative analysis using LA/LAA ratio (<0.5; accuracy: 100%, 88%,100%, 99% vs 100%). 5 out of 182 patients (2.7%) showed thrombus formation of the LAA in CCTA confirmed by TEE and quantitative analysis. Intra/-interobserver variability was lower in end-systolic vs end-diastolic reconstruction interval.
  
  
  CONCLUSIONS
  For evaluating CCTA datasets in patients prior PVI, the LVES reconstruction interval is recommended due to significantly larger LA/LAA volumes and lower intra/- interobserver variability's.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen, Germany ; DZHK, Göttingen, Germany.
authors.forename: Wieland
authors.initials: W
authors.lastname: Staab
authors.affiliation: Department of Diagnostic and Interventional Radiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen, Germany.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Goth
authors.affiliation: Department of Cardiology and Pneumology, Georg-August-University, Goettingen, Germany ; DZHK, Göttingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Sohns
authors.affiliation: Department of Diagnostic and Interventional Radiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen, Germany ; DZHK, Göttingen, Germany.
authors.forename: Jan Martin
authors.initials: JM
authors.lastname: Sohns
authors.affiliation: Department of Diagnostic and Interventional Radiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen, Germany ; DZHK, Göttingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Steinmetz
authors.affiliation: Department of Diagnostic and Interventional Radiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen, Germany ; Department of Cardiology and Pneumology, Georg-August-University, Goettingen, Germany ; DZHK, Göttingen, Germany.
authors.forename: Christina Unterberg
authors.initials: CU
authors.lastname: Buchwald
authors.affiliation: Department of Cardiology and Pneumology, Georg-August-University, Goettingen, Germany ; DZHK, Göttingen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schuster
authors.affiliation: Department of Diagnostic and Interventional Radiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen, Germany.
authors.forename: Johannes Tammo
authors.initials: JT
authors.lastname: Kowallick
authors.affiliation: Department of Diagnostic and Interventional Radiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen, Germany ; DZHK, Göttingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Fasshauer
authors.affiliation: Department of Diagnostic and Interventional Radiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen, Germany ; DZHK, Göttingen, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Lotz
keywords: LAA; PVI; Thrombus; Volumes