MRI Heart Function and Morphology Without IV Contrast MRI heart without IV contrast can provide cardiac function and chamber sizes, but the role in preprocedural planning is limited and there is scant literature on this topic. Also, unlike contrast-enhanced MRI heart, it is not sensitive for thrombus and cannot be used for scar assessment. SPECT or SPECT/CT MPI Rest and Stress There is no relevant literature to support the use of single-photon emission computed tomography (SPECT) or SPECT/CT myocardial perfusion imaging (MPI) rest and stress for to guide preprocedural planning before LA ablation. However, many operators use isoproterenol infusions to assess the presence of nonpulmonary vein triggers. Prior to using high doses of isoproterenol, assessment of MPI may be advisable in patients with symptoms consistent with angina or those with limited functional capacity. US Echocardiography Transesophageal TEE is a useful imaging technique for LA/LAA thrombus detection [38-40] and has a sensitivity of 93.3% to 100% and a specificity of 99% to 100%. TEE cannot reliably assess pulmonary venous anatomy, pulmonary venous measurements, and extracardiac anatomic relations. Hence, alternative imaging techniques like CT and MR are being assessed to allow a more targeted use of TEE in patients with suspected thrombus. US Echocardiography Transthoracic Resting Although TTE is commonly used in the initial workup of patients with AF and parameters such as LA volume/volume index, left ventricular ejection fraction [41], and LA size [42] can be assessed, there is no relevant literature that describes the specific use of TTE to guide preprocedural planning before LA ablation procedure. Left Atrial Procedures in Atrial Fibrillation Variant 2: Adult. Atrial fibrillation. Preprocedural planning prior to left atrial appendage endovascular occlusion.
Preprocedural Planning for Left Atrial Procedures in Atrial Fibrillation. MRI Heart Function and Morphology Without IV Contrast MRI heart without IV contrast can provide cardiac function and chamber sizes, but the role in preprocedural planning is limited and there is scant literature on this topic. Also, unlike contrast-enhanced MRI heart, it is not sensitive for thrombus and cannot be used for scar assessment. SPECT or SPECT/CT MPI Rest and Stress There is no relevant literature to support the use of single-photon emission computed tomography (SPECT) or SPECT/CT myocardial perfusion imaging (MPI) rest and stress for to guide preprocedural planning before LA ablation. However, many operators use isoproterenol infusions to assess the presence of nonpulmonary vein triggers. Prior to using high doses of isoproterenol, assessment of MPI may be advisable in patients with symptoms consistent with angina or those with limited functional capacity. US Echocardiography Transesophageal TEE is a useful imaging technique for LA/LAA thrombus detection [38-40] and has a sensitivity of 93.3% to 100% and a specificity of 99% to 100%. TEE cannot reliably assess pulmonary venous anatomy, pulmonary venous measurements, and extracardiac anatomic relations. Hence, alternative imaging techniques like CT and MR are being assessed to allow a more targeted use of TEE in patients with suspected thrombus. US Echocardiography Transthoracic Resting Although TTE is commonly used in the initial workup of patients with AF and parameters such as LA volume/volume index, left ventricular ejection fraction [41], and LA size [42] can be assessed, there is no relevant literature that describes the specific use of TTE to guide preprocedural planning before LA ablation procedure. Left Atrial Procedures in Atrial Fibrillation Variant 2: Adult. Atrial fibrillation. Preprocedural planning prior to left atrial appendage endovascular occlusion.