Abstract 17025: Multidetector Computer Tomography Might be an Enough Screening Test to Prevent Periprocedural Stroke in Atrial fibrillation Ablation; Multicenter Study
Background: Periprocedural stroke during atrial fibrillation (AF) ablation range between 1.5 and 5.4%. This study evaluated whether the multidetector computer tomography (MDCT) was an enough screening test to prevent periprocedural stroke in AF ablation.
Methods: At 4 tertiary centers, we enrolled 1,160 patients (909 males, mean age 57±11 years) with optimal anticoagulation and preserved left ventricular ejection function (LVEF), who had underwent MDCT and TEE (Group 1, n = 682) or MDCT alone (group 2, n = 478) for the screening test before AF ablation. In group 2, TEE was performed only in patients who had left atrial (LA) thrombus or blood stasis in MDCT.
Results: There was no difference in CHADS2 scores, LVEF and LA size between 2 groups. In group 1, a thrombus was detected in 15 (2.2%) and 10 (1.5%) patients by the MDCT and TEE, respectively. All (100%) patients, who were revealed to have thrombus in TEE, also had a thrombus in MDCT. In group 2, 14 (2.9%) patients exhibited LA thrombus in MDCT, among whom thrombus was observed in 6 patients (1.3%) in TEE. The negative predictive value of MDCT to detect the thrombus was 100%. AF ablation was not performed in patients with thrombus. Stroke occurred in a patient in each group (P = 1.0).
Conclusion: The preprocedural MDCT detected all patients with the LA thrombus. In AF patients with low CHADS2 score, optimal anticoagulation and relatively preserved LVEF, the MDCT might be enough as a screening test to prevent the periprocedural stroke.
- © 2013 by American Heart Association, Inc.