Cardiac Computed Tomograpy Technology in Interventions Related to Atrial Fibrillation
Keywords:
atrial fibrillation, Cardiac CT, transseptal puncture, percutaneous catheter radiofrequency ablation, ethanol infusion into the vein of marshall, left atrial appendage occlusion
Abstract
Atrial fibrillation represents the predominant cardiac arrhythmia encountered in the elderly population clinically. In recent years, the use of cardiac interventional therapy for atrial fibrillation has become increasingly prevalent. Cardiac computed tomograpy(CT) plays a important rolesin interventional therapy, particularly demonstrating significant importance in preoperative assessment and planning. This article reviews the applications of cardiac CT in assisting transseptal puncture, catheter radiofrequency ablation, ethanol infusion into the vein of marshall, and left atrial appendage occlusion procedures.
References
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[17] Prat-Gonzalez, S., Sanz, J., & Garcia, M. J. (2008). Cardiac CT: Indications and limitations. Journal of Nuclear Medicine Technology, 36(1), 18–24. https://doi.org/10.2967/jnmt.107.045763
[18] Saad, E. B., Rossillo, A., Schmitt, M., & Strickberger, S. A. (2003). Pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation: Functional characterization, evolution, and influence of the ablation strategy. Circulation, 108(25), 3102–3107. https://doi.org/10.1161/01.CIR.0000103759.57608.2F
[19] Takagi, T., Tada, H., & Oshima, S. (2022). Optimized computed tomography acquisition protocol for ethanol infusion into the vein of Marshall. JACC: Clinical Electrophysiology, 8(2), 168–178. https://doi.org/10.1016/j.jacep.2021.09.006
[20] Tan, M., & Yang, Y. (2022). The study of atrial septal puncture guided by left atrium CT. Chinese Journal of Evidence-Based Cardiovascular Medicine, 14(05), 606-610.
[21] Tjahjadi, N. S., van der Geest, R. J., & de Roos, A. (2025). Three-dimensional assessment of ascending aortic stiffness, motion, and growth in ascending thoracic aortic aneurysm. European Heart Journal - Cardiovascular Imaging, 3, qyae133. https://doi.org/10.1093/ehjci/qyae133
[22] Valderrábano, M., Benito, E. M., Arribas, F., Arana-Rueda, E., Ávila, P., Pérez-Castellano, J., ... & Almendral, J. (2020). Effect of catheter ablation with vein of Marshall ethanol infusion vs catheter ablation alone on persistent atrial fibrillation: The VENUS Randomized Clinical Tri 1 al. JAMA, 324(16), 1620. https://doi.org/10.1001/jama.2020.17183
[23] Wang, Y., Ma, C., & Hu, D. (2024). Chinese expert consensus on the diagnosis and treatment of atrial fibrillation in the elderly(2024). Chinese Journal of Cardiac Arrhythmias, 28(2), 103-124.
[24] Yang, Y., & Liu, X. (2010). CT diagnosis of cardiac lipoma. Chinese Journal of Radiology, 44(8), 803-806.
[25] Yuan, J. (2024). Diagnostic value of enhanced CT combined with coronary CT angiography for left atrial appendage thrombosis in patients with non-valvular atrial fibrillation. Chinese Journal of Practical Medicine, 51(5), 83-86.
[26] Zhu, N., Lin, C., Zhang, Y., & Lin, W. (2024). Case report: Vein of Marshall–catheter ablation combined with left atrial appendage occlusion for treatment of atrial fibrillation. Heliyon, 10, e38235. https://doi.org/10.1016/j.heliyon.2024.e38235
[27] Zuo, S., & Wu, J. (2021). Feasibility and safety of intracardiac ultrasound assisted atrial septal puncture during radiofrequency ablation for atrial fibrillation. Chinese Journal of Cardiology, 49(5), 474-478.
[2] Cheng, C., Zhang, Y., & Liu, X. (2024). The value of cardiac 3-dimensional computed tomography in the simplified left atrial appendage occlusion [J]. Chinese General Practice, 27(35), 4439-4445.
[3] Dinov, B., Tilz, R. R., Chun, K. R. J., Metzner, A., Wissner, E., Fuernau, G., ... & Kuck, K. H. (2014). Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: Results from the prospective Heart Centre of Leipzig VT (HELP-VT) Study. Circulation, 129(7), 728–736. https://doi.org/10.1161/CIRCULATIONAHA.113.003932
[4] Du, W., Zhang, Y., Wang, J., & Li, Y. (2020). Large left atrial appendage predicts the ablation outcome in hypertensive patients with atrial fibrillation. Journal of Electrocardiology, 63, 139–144. https://doi.org/10.1016/j.jelectrocard.2020.08.016
[5] Gao, M., Ma, C., & Hu, D. (2024). Epidemiology of atrial fibrillation in China: 20 year trend. Chinese Journal of Cardiology, 52(2), 220-226.
[6] Hindricks, G., Potpara, T. S., Dagres, N., Arbelo, E., Bax, J. J., Blomström-Lundqvist, C., ... & Heidbuchel, H. (2021). 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal, 42(5), 373–498. https://doi.org/10.1093/eurheartj/ehaa612
[7] Kassab, J., Marwan, M., Al-Hijji, M. A., Alqahtani, F., Aljizeeri, A., Al-Mallah, M. H., ... & AlBadri, A. (2023). The added value of preprocedural cardiac computed tomography in planning left atrial appendage closure with the Watchman FLX device. Structural Heart, 7, 100188. https://doi.org/10.1016/j.shj.2023.100188
[8] Klimek-Piotrowska, W., Hołda, M. K., Koziej, M., Piątek, K., & Hołda, J. (2016). Anatomy of the true interatrial septum for transseptal access to the left atrium. Annals of Anatomy - Anatomischer Anzeiger, 205, 60–64. https://doi.org/10.1016/j.aanat.2015.11.002
[9] Kočka, V., Maurovich-Horvat, P., Merkely, B., & Varga, A. (2020). Optimal fluoroscopic projections of coronary ostia and bifurcations defined by computed tomographic coronary angiography. JACC: Cardiovascular Interventions, 13(21), 2560–2570. https://doi.org/10.1016/j.jcin.2020.08.048
[10] Li, B., Chen, S., & Li, Z. (2019). Pulmonary vein parameters are similar or better predictors than left atrial diameter for paroxysmal atrial fibrillation after cryoablation. Brazilian Journal of Medical and Biological Research, 52(10), e8446. https://doi.org/10.1590/1414-431X20198446
[11] Li, R., & Ma, C. (2021). Progress of anticoagulant treatment of left atrial thrombus in patients with non-valvular atrial fibrillation. Chinese Journal of Cardiac Arrhythmias, 25(5), 449-453.
[12] Magnocavallo, M., Di Biase, L., Mohanty, S., Trivedi, C., Gianni, C., Burkhardt, J. D., ... & Natale, A. (2022). Catheter ablation versus medical therapy of atrial fibrillation in patients with heart failure: An updated systematic review and meta-analysis of randomized controlled trials. Journal of Clinical Medicine, 11(18), 5530. https://doi.org/10.3390/jcm11185530
[13] Manjunath, R., Kulkarni, A., & Kulkarni, V. (2024). Segmentation and volumetric analysis of heart from cardiac CT images. Cardiovascular Engineering and Technology, 15, 383–393. https://doi.org/10.1007/s13239-023-00720-3
[14] Nakatani, Y., Tada, H., & Oshima, S. (2018). Heterogeneity in the left atrial wall thickness contributes to atrial fibrillation recurrence after catheter ablation. Heart and Vessels, 33(12), 1549–1558. https://doi.org/10.1007/s00380-018-1218-4
[15] Nelles, D., Sommer, P., & Arya, A. (2023). The CT derived angle between the transseptal puncture site and the left atrial appendage as a predictor for complex interventional occlusion procedures. Echocardiography, 40(10), 1227–1236. https://doi.org/10.1111/echo.15783
[16] Nunes‐Ferreira, A., Providencia, R., & Lambiase, P. D. (2025). Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease. Journal of Arrhythmia, 41, e13205. https://doi.org/10.1002/joa3.13205
[17] Prat-Gonzalez, S., Sanz, J., & Garcia, M. J. (2008). Cardiac CT: Indications and limitations. Journal of Nuclear Medicine Technology, 36(1), 18–24. https://doi.org/10.2967/jnmt.107.045763
[18] Saad, E. B., Rossillo, A., Schmitt, M., & Strickberger, S. A. (2003). Pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation: Functional characterization, evolution, and influence of the ablation strategy. Circulation, 108(25), 3102–3107. https://doi.org/10.1161/01.CIR.0000103759.57608.2F
[19] Takagi, T., Tada, H., & Oshima, S. (2022). Optimized computed tomography acquisition protocol for ethanol infusion into the vein of Marshall. JACC: Clinical Electrophysiology, 8(2), 168–178. https://doi.org/10.1016/j.jacep.2021.09.006
[20] Tan, M., & Yang, Y. (2022). The study of atrial septal puncture guided by left atrium CT. Chinese Journal of Evidence-Based Cardiovascular Medicine, 14(05), 606-610.
[21] Tjahjadi, N. S., van der Geest, R. J., & de Roos, A. (2025). Three-dimensional assessment of ascending aortic stiffness, motion, and growth in ascending thoracic aortic aneurysm. European Heart Journal - Cardiovascular Imaging, 3, qyae133. https://doi.org/10.1093/ehjci/qyae133
[22] Valderrábano, M., Benito, E. M., Arribas, F., Arana-Rueda, E., Ávila, P., Pérez-Castellano, J., ... & Almendral, J. (2020). Effect of catheter ablation with vein of Marshall ethanol infusion vs catheter ablation alone on persistent atrial fibrillation: The VENUS Randomized Clinical Tri 1 al. JAMA, 324(16), 1620. https://doi.org/10.1001/jama.2020.17183
[23] Wang, Y., Ma, C., & Hu, D. (2024). Chinese expert consensus on the diagnosis and treatment of atrial fibrillation in the elderly(2024). Chinese Journal of Cardiac Arrhythmias, 28(2), 103-124.
[24] Yang, Y., & Liu, X. (2010). CT diagnosis of cardiac lipoma. Chinese Journal of Radiology, 44(8), 803-806.
[25] Yuan, J. (2024). Diagnostic value of enhanced CT combined with coronary CT angiography for left atrial appendage thrombosis in patients with non-valvular atrial fibrillation. Chinese Journal of Practical Medicine, 51(5), 83-86.
[26] Zhu, N., Lin, C., Zhang, Y., & Lin, W. (2024). Case report: Vein of Marshall–catheter ablation combined with left atrial appendage occlusion for treatment of atrial fibrillation. Heliyon, 10, e38235. https://doi.org/10.1016/j.heliyon.2024.e38235
[27] Zuo, S., & Wu, J. (2021). Feasibility and safety of intracardiac ultrasound assisted atrial septal puncture during radiofrequency ablation for atrial fibrillation. Chinese Journal of Cardiology, 49(5), 474-478.
Published
2025-03-08
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