Multidetector 16-slice CT scan evaluation of cavotricuspid isthmus anatomy before radiofrequency ablation
| Autor: | Sébastien Knecht, Thierry William Verbeet, Jose A. Castro-Rodriguez, Emmanuel Tran-Ngoc, Valentin Tatnga, Merieme Elkholti, Pierre Decoodt, Marielle Morissens, Nasroola Damry, Béatrice Peperstraete |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Radiofrequency ablation medicine.medical_treatment Catheter ablation Inferior vena cava law.invention law Heart Conduction System Physiology (medical) Typical atrial flutter Atrial Fibrillation Preoperative Care medicine Humans Coronary sinus Aged Aged 80 and over business.industry Patient Selection Coronary Sinus Atrial fibrillation Anatomy Middle Aged medicine.disease Ablation Prognosis Treatment Outcome medicine.vein Atrial Flutter Surgery Computer-Assisted Catheter Ablation Radiology Tricuspid Valve Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed Atrial flutter |
| Zdroj: | Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing. 20(1-2) |
| ISSN: | 1383-875X |
| Popis: | The anatomy of the cavotricuspid isthmus (CTI) is an important determinant of the ease of radiofrequency ablation. We evaluated the anatomy of the region with a multidetector 16-slice computed tomography (CT) scan and correlated this with subsequent procedural difficulty.Twenty-nine patients (mean age 64 +/- 15 years) with typical atrial flutter or paroxysmal atrial fibrillation underwent ablation of the CTI. A multidetector 16-slice CT scan with contrast injection was performed in all before the procedure.The CTI showed marked variability as evidenced by the following measurements: length (8.2 to 32.2 mm), width (26 to 56.5 mm), depth (0 to 11 mm), thickness (0.2 to 7.5 mm), the angle between the inferior vena cava and the CTI (59.9 to 129.5 degrees ), and the length of the Eustachian valve (4.8 to 26.1 mm) present in 72% of patients. The appearance of the CTI was classified as follows into three categories: concave (72%), flat (17%), or with a sub-Eustachian recess (28%). Procedures were classified as difficult in case of failure to achieve bidirectional block or if radiofrequency duration was greater than 99% confidence interval. In the multivariate analysis, a significant correlation was present between the thickness of the CTI and procedural difficulty (p = 0.0005).The multidetector 16-slice CT scan with contrast injection accurately evaluates the anatomy of the CTI. The only independent anatomic parameter that predicts a more difficult procedure is the thickness of the CTI. |
| Databáze: | OpenAIRE |
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