Welcome to the UPF Digital Repository

Cardiac tomography and cardiac magnetic resonance to predict the absence of intracardiac thrombus in anticoagulated patients undergoing atrial fibrillation ablation

Show simple item record

dc.contributor.author Zaraket, Fatima
dc.contributor.author Bas, Deva
dc.contributor.author Jiménez, Jesús
dc.contributor.author Casteigt, Benjamin
dc.contributor.author Benito, Begoña
dc.contributor.author Martí Almor, Julio
dc.contributor.author Conejos, Javi
dc.contributor.author Tizón-Marcos, Helena
dc.contributor.author Mojón Álvarez, Diana
dc.contributor.author Vallés Gras, Ermengol
dc.date.accessioned 2022-11-15T08:29:33Z
dc.date.available 2022-11-15T08:29:33Z
dc.date.issued 2022
dc.identifier.citation Zaraket F, Bas D, Jimenez J, Casteigt B, Benito B, Martí-Almor J, et al. Cardiac tomography and cardiac magnetic resonance to predict the absence of intracardiac thrombus in anticoagulated patients undergoing atrial fibrillation ablation. J Clin Med. 2022 Apr 8; 11(8): 2101. DOI: 10.3390/jcm11082101.
dc.identifier.issn 2077-0383
dc.identifier.uri http://hdl.handle.net/10230/54849
dc.description.abstract Background: pulmonary veins isolation (PVI) is a standard treatment for recurrent atrial fibrillation (AF). Uninterrupted anticoagulation for a minimum of 3 weeks before ablation and exclusion of left atrial (LA) thrombus with transesophageal echography (TEE) immediately before or during the procedure minimize peri-procedural risk. We aimed to demonstrate the utility of cardiac tomography (CT) and cardiac magnetic resonance (CMR) to rule out LA thrombus prior to PVI. Methods: patients undergoing PVI for recurrent AF were retrospectively evaluated. Only patients that started anticoagulation at least 3 weeks prior to the CT/CMR and subsequently uninterrupted until the ablation procedure were selected. An intracardiac echo (ICE) catheter was used in all patients to evaluate LA thrombus. The results of CT/CMR were compared to ICE imaging. Results: we included 272 consecutive patients averaging 54.5 years (71% male; 30% persistent AF). Average CHA2DS2VASC score was 0.9 ± 0.83 and mean LA diameter was 42 ± 5.7 mm, 111 (41%) patients were on Acenocumarol and 161 (59%) were on direct oral anticoagulants. Anticoagulation was started 227 ± 392 days before the CT/CMR, and 291 ± 416 days before the ablation procedure. CT/CMR diagnosed intracardiac thrombus in two cases, both in the LA appendage. A new CT/CMR revealed resolution of thrombus after six additional months of uninterrupted anticoagulation. No macroscopic thrombus was observed in any patients with ICE (negative predictive value of 100%; p < 0.01). Conclusions: CT and MRI are excellent surrogates to TEE and ICE to rule out intracardiac thrombus in patients adequately anticoagulated prior AF ablation. This is true even for delayed procedures as long as anticoagulation is uninterrupted.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher MDPI
dc.rights Copyright © 2022. Zaraket F, Bas D, Jimenez J, Casteigt B, Benito B, Martí-Almor J, et al. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Cardiac tomography and cardiac magnetic resonance to predict the absence of intracardiac thrombus in anticoagulated patients undergoing atrial fibrillation ablation
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.3390/jcm11082101
dc.subject.keyword Advanced imaging techniques
dc.subject.keyword Atrial fibrillation
dc.subject.keyword Atrial fibrillation ablation
dc.subject.keyword Intracardiac echography
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

Thumbnail

This item appears in the following Collection(s)

Show simple item record

Search DSpace


Advanced Search

Browse

My Account

Statistics

In collaboration with Compliant to Partaking