Perna F, Casella M, Narducci ML, Dello Russo A, Bencardino G, Pontone G, Pelargonio G, Andreini D, Vitulano N, Pizzamiglio F, Conte E, Crea F, Tondo C. Collateral findings during computed tomography scan for atrial fibrillation ablation: Let’s take a look around. World J Cardiol 2016; 8(4): 310-316 [PMID: 27152143 DOI: 10.4330/wjc.v8.i4.310]
Corresponding Author of This Article
Francesco Perna, MD, PhD, Cardiac Arrhythmia Unit, Agostino Gemelli University Hospital, Largo Agostino Gemelli 8, 00168 Rome, Italy. francperna@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Apr 26, 2016; 8(4): 310-316 Published online Apr 26, 2016. doi: 10.4330/wjc.v8.i4.310
Collateral findings during computed tomography scan for atrial fibrillation ablation: Let’s take a look around
Francesco Perna, Michela Casella, Maria Lucia Narducci, Antonio Dello Russo, Gianluigi Bencardino, Gianluca Pontone, Gemma Pelargonio, Daniele Andreini, Nicola Vitulano, Francesca Pizzamiglio, Edoardo Conte, Filippo Crea, Claudio Tondo
Francesco Perna, Maria Lucia Narducci, Gianluigi Bencardino, Gemma Pelargonio, Nicola Vitulano, Filippo Crea, Cardiac Arrhythmia Unit, Agostino Gemelli University Hospital, 00168 Rome, Italy
Michela Casella, Antonio Dello Russo, Gianluca Pontone, Daniele Andreini, Francesca Pizzamiglio, Edoardo Conte, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
Author contributions: Perna F and Casella M wrote the paper; Narducci ML, Dello Russo A, Bencardino G, Pontone G, Pelargonio G and Andreini D revised the paper; Vitulano N, Pizzamiglio F and Conte E provided the images and elaborated critical concepts of the paper; Crea F and Tondo C provided the final revision and approval of the paper.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Francesco Perna, MD, PhD, Cardiac Arrhythmia Unit, Agostino Gemelli University Hospital, Largo Agostino Gemelli 8, 00168 Rome, Italy. francperna@gmail.com
Telephone: +39-06-30154187
Received: August 11, 2015 Peer-review started: August 11, 2015 First decision: October 8, 2015 Revised: November 7, 2015 Accepted: January 16, 2016 Article in press: January 19, 2016 Published online: April 26, 2016 Processing time: 251 Days and 2.1 Hours
Abstract
The growing number of atrial fibrillation catheter ablation procedures warranted the development of advanced cardiac mapping techniques, such as image integration between electroanatomical map and cardiac computed tomography. While scanning the chest before catheter ablation, it is frequent to detect cardiac and extracardiac collateral findings. Most collateral findings are promptly recognized as benign and do not require further attention. However, sometimes clinically relevant collateral findings are detected, which often warrant extra diagnostic examinations or even invasive procedure, and sometimes need to be followed-up over time. Even though reporting and further investigating collateral findings has not shown a clear survival benefit, almost all the working groups providing data on collateral findings reported some collateral findings eventually coming out to be malignancies, sometimes at an early stage. Therefore, there is currently no clear agreement about the right strategy to be followed.
Core tip: Several cardiac computed tomography (CT) scans are performed worldwide in order to better delineate left atrial anatomy before atrial fibrillation (AF) ablation. A thorough examination of the entire field of view often discovers cardiac or extra-cardiac collateral findings, which might represent potentially malignant diseases. Early detection of such diseases may guarantee a curative treatment. Our objective is to consolidate the current literature about collateral findings detected at cardiac CT before AF ablation and to highlight the potential implications of systematically reporting and following up such findings.
