Role of Transesophageal Echocardiography Compared to Computed Tomography in Evaluation of Pulmonary Vein Ablation for Atrial Fibrillation (ROTEA Study)

To, Andrew; Gabriel, Ruvin; Park, Margaret; Lowe, Boris S.; Curtin, Ronan J.; Sigurðsson, Garðar; Sherman, Minerva; Wazni, Oussama; Saliba, Walid; Bhargava, Mandeep; Lindsay, Bruce D.; Klein, Allan L.

doi:10.1016/j.echo.2011.05.014

Cited by 22 publications

(16 citation statements)

References 24 publications

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“…There are comparative data between modalities (37,38), but no study integrates all imaging modalities so a complete comparison is lacking. However, cardiac CT and CMR provide superior spatial resolution over ultrasound (39,40), and can also be co-registered with electroanatomical mapping systems (9). Each has advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 99%

The Incidence, Pattern, and Prognostic Value of Left Ventricular Myocardial Scar by Late Gadolinium Enhancement in Patients With Atrial Fibrillation

Neilan

Shah

Abbasi

et al. 2013

Journal of the American College of Cardiology

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Objectives We aimed to identify the frequency, pattern, and prognostic significance of left ventricular (LV) late gadolinium enhancement (LGE) in patients with atrial fibrillation (AF). Background There are limited data on the presence, pattern, and prognostic significance of LV myocardial fibrosis in patients with AF. Late gadolinium enhancement during cardiac magnetic resonance (CMR) is a marker for myocardial fibrosis. Methods We studied a consecutive group of 664 patients without known prior myocardial infarction being referred for radiofrequency ablation of AF. CMR was requested to assess pulmonary venous anatomy. Results Overall, 73% were male, with an average age of 56 years, and an ejection fraction of 55±10%. Left ventricular LGE was found in 88 patients (13%). The endpoint was all-cause mortality, and in this cohort we observed 68 deaths over a median follow-up period of 42 months. On univariable analysis, age (HR 1.05, CI 1.03–1.08, LRχ2 15.2, p=0.0001), diabetes (HR 2.39, CI 1.41–4.09, LRχ210.3, p=0.001), a history of heart failure (HR 1.78, CI 1.09–2.91, LRχ2 5.37, p=0.02), left atrial dimension (HR 1.04, CI 1.01–1.08, LRχ2 6.47, p=0.01), presence of LGE (HR 5.08, CI 3.08–8.36, LRχ2 28.8, p<0.0001), and LGE extent (HR 1.15, CI 1.10–1.21, LRχ2 35.6, p<0.0001) provided the strongest association with mortality. The mortality rate was 8.1% per patient-years in patients with LGE vs. 2.3% patients without LGE. In the best overall multivariable model for mortality, age and the extent of LGE were independent predictors of mortality. Indeed, each 1% increase in LGE associated with a 15% increased risk of death. Conclusions In patients with AF, LV LGE is a frequent finding and is a powerful predictor of mortality.

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Section: Discussionmentioning

confidence: 99%

The Incidence, Pattern, and Prognostic Value of Left Ventricular Myocardial Scar by Late Gadolinium Enhancement in Patients With Atrial Fibrillation

Neilan

Shah

Abbasi

et al. 2013

Journal of the American College of Cardiology

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“…72,73 Head-to-head comparisons of the different techniques suggest that CT likely provides the most accurate assessment of PV anatomy and is therefore the most common modality for PV stenosis evaluation. [74][75][76] On the other hand, echocardiography and lung ventilation-perfusion scanning can help determine the functional significance of PV stenosis. Therefore, a multimodal approach should be used when PV stenosis is suspected.…”

Section: Pulmonary Veinsmentioning

confidence: 99%

Atrial Fibrillation Pathophysiology and Prognosis

Siontis

Gersh

2015

Circ: Cardiovascular Imaging

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“…PV dimensions on TOE may be underestimated, especially the inferior PVs [63]. Due to the high spatial resolution in all imaging planes, it has a distinct advantage to reli ably measure PV diameters, and compare these to preprocedural values.…”

Section: Complicationsmentioning

confidence: 99%