ArticleJournal of cardiovascular electrophysiology2025
The Single-Delayed-Phase Contrast Computed Tomography Before Ablation to Reduce Radiation Exposure Without Compromising Diagnostic Pulmonary Vein Accuracy.
Article in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
Authors and funding
9 authors.
Funding
Abstract
introductionEarly-phase contrast-enhanced CT (CCT) is often used to plan and guide catheter ablation for atrial fibrillation (AF), and delayed-phase images can be used to detect or exclude left atrial appendage (LAA) thrombosis. However, dual-phase CCT is associated with concerns about radiation exposure; hence, this study aimed to evaluate whether single-delayed-phase images can provide sufficient preoperative information while minimizing radiation exposure. METHODS AND
resultsA total of 102 patients who underwent dual-phase CCT were analyzed for pulmonary vein (PV) anatomy and LAA thrombus detection. The decrease in image quality due to the difference between early and delayed phases in 3D reconstruction did not pose a problem regarding anatomical evaluation. The PV anatomy was classified as typical or atypical, and 399 PVs were analyzed. Atypical PVs included 17 cases, with consistent anatomical details across the early and delayed phases. The mean discrepancy in PV diameter between the two phases and the correlation coefficient for the coronal view was 0.78 ± 0.16 mm, r = 0.91, and for the axial view, 0.79 ± 0.15 mm, r = 0.93. The LAA thrombi were observed in three patients, and no thrombus was overestimated in the delayed phase. The total exposure dose was 2320.1 ± 1031.0 mGy-cm in the dual-phase, 1443.3 ± 578.5 mGy-cm in the single early phase, and 876.8 ± 526.6 mGy-cm in the single delayed phase. Radiation doses were significantly lower in single-phase imaging than in dual-phase.
conclusionsThe single-delayed-phase CCT provides accurate anatomical and thrombus evaluations while significantly reducing radiation exposure. This approach could be a safer alternative for pre-ablation assessment without compromising diagnostic reliability.
trial registrationThe University of Occupational and Environmental Health ethics committee approved the study (UOEHCRB22-067).
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