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Cardiac CTA: Electrophysiology

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Coronary Artery CTA

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Abstract

Cardiac computed tomography angiogram (CCTA) has evolved from a simple structural assessment tool to a key instrument used for complex ablation procedures in clinical cardiac electrophysiology. CCTA’s fast acquisition and better image resolution allow for precise anatomic assessment that increases the efficacy and safety of these procedures.

CCTA has become integral in preparing for left atrial-based electrophysiology (EP) procedures, such as atrial fibrillation (AF) ablation. The cornerstone of AF ablation procedures is application of radiofrequency energy in a wide circumferential manner around the antrum of the pulmonary veins. Prior to insertion of catheters into the left atrium, it is essential to assess number of pulmonary veins present, the presence of common pulmonary vein antrums, and the presence of potentially impending structures such as left atrial diverticula and the presence of cor triatriatum. In addition, in preparation for AF ablation in patients who had previous left atrial ablation, it is mandatory to assess for iatrogenic pulmonary vein stenosis. Evaluation of these structures is performed with volume rendering into a three-dimensional (3D) reconstruction. 3D CT images are reconstructed and vascular and coronary structural images are segmented away until pulmonary venous and left atrial anatomies are isolated for a more focused evaluation.

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Authors and Affiliations

  1. Department of Medicine, University of Miami at Holy Cross Hospital, Fort Lauderdale, FL, USA

    John J. Lee MD

  2. Electrophysiology Lab, Department of Cardiology, Holy Cross Hospital, Fort Lauderdale, FL, USA

    Rishi Anand MD & Daniel Weitz MD

Authors
  1. John J. Lee MD
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  2. Rishi Anand MD
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  3. Daniel Weitz MD
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Corresponding author

Correspondence to Daniel Weitz MD .

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Editors and Affiliations

  1. Department of Radiology, Holy Cross Hospital, South Florida Medical Imaging Cardiovascular Institute, Fort Lauderdale, Florida, USA

    Claudio Smuclovisky

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Lee, J.J., Anand, R., Weitz, D. (2018). Cardiac CTA: Electrophysiology. In: Smuclovisky, C. (eds) Coronary Artery CTA. Springer, Cham. https://doi.org/10.1007/978-3-319-66988-5_13

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  • DOI: https://doi.org/10.1007/978-3-319-66988-5_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66986-1

  • Online ISBN: 978-3-319-66988-5

  • eBook Packages: MedicineMedicine (R0)

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