There is no relevant literature to support the use of CT chest with IV contrast to guide preprocedural planning for cardioversion. CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast to guide preprocedural planning for cardioversion. CT Chest Without IV Contrast There is no relevant literature to support the use of CT chest without IV contrast to guide preprocedural planning for cardioversion. CT Heart Function and Morphology With IV Contrast There is increasing use of CT to exclude thrombus before LA procedures, especially when CT is already being performed for measurements and mapping (ie, before ablation and appendage occlusion). However, there are no large studies assessing the role of CT before cardioversion. In terms of diagnostic accuracy, CT has shown good performance for this indication (exclusion of thrombus), with a meta-analysis showing CT to have a sensitivity and specificity of 96% and 92%, respectively, which increased to 100% and 99%, respectively, if delayed imaging was performed [48]. Other studies have shown similar results [18,19,25]. CT has the advantage of noninvasive nature with 3-D capability. CTA Chest With IV Contrast Depending on the exact parameters, CTA with IV contrast is useful in excluding thrombi especially when combined with delayed imaging. When coupled with delayed phase it has a 100% sensitivity and NPV [48]. CTA Coronary Arteries With IV Contrast There is no relevant literature to support the use of CTA coronary arteries with IV contrast to guide preprocedural planning for cardioversion. MRA Chest Without and With IV Contrast MRA with IV contrast can identify LA/LAA thrombi with an accuracy of 94.3%, a sensitivity of 66.7%, and a specificity of 95.2% compared with TEE [28].
Preprocedural Planning for Left Atrial Procedures in Atrial Fibrillation. There is no relevant literature to support the use of CT chest with IV contrast to guide preprocedural planning for cardioversion. CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast to guide preprocedural planning for cardioversion. CT Chest Without IV Contrast There is no relevant literature to support the use of CT chest without IV contrast to guide preprocedural planning for cardioversion. CT Heart Function and Morphology With IV Contrast There is increasing use of CT to exclude thrombus before LA procedures, especially when CT is already being performed for measurements and mapping (ie, before ablation and appendage occlusion). However, there are no large studies assessing the role of CT before cardioversion. In terms of diagnostic accuracy, CT has shown good performance for this indication (exclusion of thrombus), with a meta-analysis showing CT to have a sensitivity and specificity of 96% and 92%, respectively, which increased to 100% and 99%, respectively, if delayed imaging was performed [48]. Other studies have shown similar results [18,19,25]. CT has the advantage of noninvasive nature with 3-D capability. CTA Chest With IV Contrast Depending on the exact parameters, CTA with IV contrast is useful in excluding thrombi especially when combined with delayed imaging. When coupled with delayed phase it has a 100% sensitivity and NPV [48]. CTA Coronary Arteries With IV Contrast There is no relevant literature to support the use of CTA coronary arteries with IV contrast to guide preprocedural planning for cardioversion. MRA Chest Without and With IV Contrast MRA with IV contrast can identify LA/LAA thrombi with an accuracy of 94.3%, a sensitivity of 66.7%, and a specificity of 95.2% compared with TEE [28].