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Contrast-enhanced computed tomography in the venous rather than the arterial phase is essential for the evaluation of the right phrenic nerve.
Tsuji, Toshihiko; Aoyama, Daisetsu; Ishida, Tomokazu; Nomura, Ryohei; Kakehashi, Shota; Mukai, Moe; Hasegawa, Kanae; Uzui, Hiroyasu; Tada, Hiroshi.
Afiliación
  • Tsuji T; Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
  • Aoyama D; Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
  • Ishida T; Department of Radiography, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
  • Nomura R; Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
  • Kakehashi S; Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
  • Mukai M; Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
  • Hasegawa K; Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
  • Uzui H; Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
  • Tada H; Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Pacing Clin Electrophysiol ; 46(12): 1526-1535, 2023 12.
Article en En | MEDLINE | ID: mdl-37899685
BACKGROUND: Preprocedural detection of the running course of the right pericardiophrenic bundles (PBs) is considered to be useful in preventing phrenic nerve (PN) injury during catheter ablation for atrial fibrillation (AF). However, previous studies using the arterial phase of contrast-enhanced computed tomography (CT) reported a relatively low right PBs detection rate. METHODS: This study included 63 patients with AF who underwent catheter ablation and preoperative contrast-enhanced CT imaging of the venous and arterial phases (66.7 ± 10.2 years; 44 male). The venous phase of contrast-enhanced CT significantly improved the detection rate of PBs compared to the arterial phase (96.8% vs. 60.3%, p < .001), and PBs were detected in the venous phase only in 23 (36.7%) patients. No significant differences were observed between the right PBs detection rate using non-contrast CT versus the arterial phase of contrast-enhanced CT (p = .37). Patients without visualization of the right PBs during the arterial phase had a higher frequency of chronic heart failure (p = .0083), lower left ventricular ejection fraction (p = .021), and a higher CHADS2 score (p = .048) than those with visualization. In five patients whose right PBs could only be detected during the venous phase of contrast-enhanced CT, the reconstructed running course of the right PBs corresponded with the PN generated by electrical high-output pacing. CONCLUSION: Contrast-enhanced CT images of the venous phase, rather than the arterial phase, are useful in detecting the right PBs, especially in patients with heart failure or reduced left ventricular ejection fraction.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Venas Pulmonares / Fibrilación Atrial / Ablación por Catéter / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Pacing Clin Electrophysiol Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Venas Pulmonares / Fibrilación Atrial / Ablación por Catéter / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Pacing Clin Electrophysiol Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos