Universität zu Köln

Sohns, J. M., Menke, J., Staab, W., Spiro, J., Fasshauer, M., Kowallick, J. T., Bergau, L., Zwaka, P. A., Unterberg-Buchwald, C., Lotz, J. and Schwarz, A. (2014). Current Role of Cardiac and Extra-Cardiac Pathologies in Clinically Indicated Cardiac Computed Tomography with Emphasis on Status Before Pulmonary Vein Isolation. Rofo-Fortschr. Gebiet Rontgenstrahlen Bildgeb. Verfahr., 186 (9). S. 860 - 868. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-9010

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Abstract

Purpose: The aim of this study was to assess the incidence of cardiac and significant extra-cardiac findings in clinical computed tomography of the heart in patients with atrial fibrillation before pulmonary vein isolation (PVI). Materials and Methods: 224 patients (64 +/- 10 years; male 63 %) with atrial fibrillation were examined by cardiac 64-slice multidetector CT before PVI. Extra-cardiac findings were classified as significant if they were recommended to additional diagnostics or therapy, and otherwise as non-significant. Additionally, cardiac findings were documented in detail. Results: A total of 724 cardiac findings were identified in 203 patients (91 % of patients). Additionally, a total of 619 extra-cardiac findings were identified in 179 patients (80 % of patients). Among these extra-cardiac findings 196 (32 %) were significant, and 423 (68 %) were non-significant. In 2 patients (1 %) a previously unknown malignancy was detected (esophageal cancer and lung cancer, local stage, no metastasis). 203 additional imaging diagnostics followed to clarify the significant findings (124 additional CT, costs 38 314.69 US dollars). Overall, there were 3.2 cardiac and 2.8 extra-cardiac findings per patient. Extra-cardiac findings appear significantly more frequently in patients over 60 years old, in smokers and in patients with a history of cardiac findings (p < 0.05). Conclusion: Cardiac CT scans before PVI should be screened for extracardiac incidental findings that could have important clinical implications for each patient. Key points: Cardiac and extra-cardiac findings are common in patients with an indication for pulmonary vein isolation on previous CT scans. Malignancies can be detected in 1 % of all patients. 32 % of all extra-cardiac findings can be of significant relevance with consequences for patients. Altogether, there are 3.2 cardiac and 2.8 extra-cardiac findings in patients with indication for pulmonary vein isolation and CT. Extra-cardiac findings appear significantly more frequently in patients over 60 years old, in smokers and in patients with a history of cardiac findings (p < 0.05). Citation Format:. Sohns JM, Menke J, Staab W et al. Current Role of Cardiac and Extra-Cardiac Pathologies in Clinically Indicated Cardiac Computed Tomographywith Emphasis on Status Before Pulmonary Vein Isolation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sohns, J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Menke, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Staab, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Spiro, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fasshauer, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kowallick, J. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bergau, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zwaka, P. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Unterberg-Buchwald, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lotz, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwarz, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-430440
DOI:	10.1055/s-0034-1366107
Journal or Publication Title:	Rofo-Fortschr. Gebiet Rontgenstrahlen Bildgeb. Verfahr.
Volume:	186
Number:	9
Page Range:	S. 860 - 868
Date:	2014
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1438-9010
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RADIOFREQUENCY CATHETER ABLATION; INCIDENTAL EXTRACARDIAC FINDINGS; FIELD-OF-VIEW; ATRIAL-FIBRILLATION; CORONARY-ANGIOGRAPHY; NONCARDIAC FINDINGS; DIAGNOSTIC-ACCURACY; IMAGE INTEGRATION; CT ANGIOGRAPHY; PREVALENCE Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43044