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      Extracardiac findings on cardiac computed tomography in patients undergoing atrial fibrillation catheter ablation

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          Abstract

          Abstract Background and Aim

          To assess the prevalence of incidental extracardiac findings in patients who underwent cardiac CT for the evaluation of left atrial (LA) anatomy before atrial fibrillation (AF) catheter ablation. We also aimed to determine the independent predictors of relevant extracardiac alterations.

          Patients and Methods

          We studied consecutive patients who underwent cardiac CT with a 256-slice scanner for the visualization of LA anatomy before AF ablation. Prevalence of clinically significant and not significant extracardiac findings were recorded. Moreover, we determined the variables associated with relevant extracardiac alterations with uni- and multivariate logistic regression analyses.

          Results

          In total, 1,952 consecutive patients who underwent cardiac CT examination between 2010 and 2020 were included in our study (mean age 61.2±10.6 years; 66.2% male). Incidental extracardiac findings were detected in 820 (42.0%; 95%CI=0.40-0.44%) patients, while clinically significant alterations were reported in 416 (21.3%; 95%CI=20.0-23.2%) patients. When analyzing the predictors of clinically relevant alterations, age (OR=1.04; 95%CI=1.03- 1.05), male sex (OR=1.39; 95%CI=1.12-1.73), chest pain (OR=1.46; 95%CI=1.09-1.93), hypertension (OR=1.42; 95%CI=1.12-1.81), heart failure (OR=1.68; 95%CI=1.09-2.53), obstructive CAD (OR=1.56; 95%CI=1.16-2.09) and prior stroke/TIA (OR=1.56; 95%CI=1.04- 2.30) showed association with clinically significant incidental findings in the univariate analysis (all p<0.05). In the multivariate analysis, age (OR=1.04; 95%CI=1.02-1.06; p<0.001) proved to be the only significant predictor of clinically relevant extracardiac finding.

          Conclusion

          Cardiac CT performed before AF ablation is not only helpful in understanding LA anatomy, but might also identify clinically significant pathologies. These incidental findings might have further diagnostic or therapeutic consequences.

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          Author and article information

          Contributors
          Journal
          1647
          Imaging
          Imaging
          Akadémiai Kiadó (Budapest )
          2732-0960
          20 January 2022
          Affiliations
          [1 ] MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University , 18 Határőr Street, 1122, Budapest, Hungary
          [2 ] Medical Imaging Centre, Semmelweis University , 2 Korányi Sándor Street, 1083, Budapest, Hungary
          [3 ] Heart and Vascular Center, Semmelweis University , 68 Városmajor Street, 1122, Budapest, Hungary
          Author notes
          [* ]Corresponding author Pál Maurovich-Horvat MD PhD MPH DSc E-mail: maurovich.horvat@ 123456gmail.com Telephone: +36/1-210-0300/53312 Fax: +36/1-459-1500/53171
          Article
          2022.00057
          10.1556/1647.2022.00057
          aa851eb0-5d6d-4a34-87de-746c939861ad
          © 2022 The Author(s)

          Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated. (SID_1)

          Page count
          Equations: 0, References: 30, Pages: 29
          Custom metadata
          1

          Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
          Incidental findings,x-ray computed,Tomography

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