Skip to main content

Advertisement

SpringerLink
Log in

Endocardial irregularities of the left atrial roof as seen on coronary CT angiography

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Objective To describe and characterize morphological characteristics of endocardial irregularities in the roof of the left atrium as seen on coronary CT angiography. Methods We retrospectively evaluated the left atrium in 50 consecutive coronary CT patients with multiplanar reformatting, volume rendering, and virtual endoscopy. Results Twenty-one of the 50 patients had an endocardial irregularity at the roof of the left atrium. The most common finding (n = 14) was a smooth diverticulum, arising near the venoatrial junction of the right superior pulmonary vein. Conclusion Endocardial irregularities of the left atrium can be identified on coronary CT and may be more common than previously considered. The findings probably represent remnants of the cardinal venous system during embryological development. Further work should focus on the true prevalence and potential clinical significance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Cronin P, Sneider MB, Kazerooni EA et al (2004) MDCT of the left atrium and pulmonary veins in planning radiofrequency ablation for atrial fibrillation: a how-to guide. AJR Am J Roentgenol 183:767–778

    PubMed  Google Scholar 

  2. Stanford W, Breen JF (2005) CT evaluation of left atrial pulmonary venous anatomy. Int J Cardiovasc Imaging 21:133–139

    Article  PubMed  Google Scholar 

  3. Oral H, Scharf C, Chugh A et al (2003) Catheter ablation for paroxysmal atrial fibrillation: segmental pulmonary vein ostial ablation versus left atrial ablation. Circulation 108:2355–2360

    Article  PubMed  Google Scholar 

  4. Jongbloed MR, Bax JJ, Lamb HJ et al (2005) Multislice computed tomography versus intracardiac echocardiography to evaluate the pulmonary veins before radiofrequency catheter ablation of atrial fibrillation: a head-to-head comparison. J Am Coll Cardiol 45:343–350

    Article  PubMed  Google Scholar 

  5. Lemola K, Sneider M, Desjardins B et al (2004) Computed tomographic analysis of the anatomy of the left atrium and the esophagus: implications for left atrial catheter ablation. Circulation 110:3655–3660

    Article  PubMed  Google Scholar 

  6. Kistler PM, Rajappan K, Jahngir M et al (2006) The impact of CT image integration into an electroanatomic mapping system on clinical outcomes of catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol 17:1093–1101

    Article  PubMed  Google Scholar 

  7. Malchano ZJ, Neuzil P, Cury RC et al (2006) Integration of cardiac CT/MR imaging with three-dimensional electroanatomical mapping to guide catheter manipulation in the left atrium: implications for catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol 17:1221–1229

    Article  PubMed  Google Scholar 

  8. Ghaye B, Szapiro D, Dacher JN et al (2003) Percutaneous ablation for atrial fibrillation: the role of cross-sectional imaging. Radiographics 23 Spec No:S19–S33. Discussion S48–S50

  9. Lacomis JM, Goitein O, Deible C, Schwartzman D (2007) CT of the pulmonary veins. J Thorac Imaging 22:63–76

    Article  PubMed  Google Scholar 

  10. Lacomis JM, Wigginton W, Fuhrman C, Schwartzman D, Armfield DR, Pealer KM (2003) Multi-detector row CT of the left atrium and pulmonary veins before radio-frequency catheter ablation for atrial fibrillation. Radiographics 23 Spec No:S35–S48. Discussion S48–S50

  11. Wongcharoen W, Tsao HM, Wu MH et al (2006) Morphologic characteristics of the left atrial appendage, roof, and septum: implications for the ablation of atrial fibrillation. J Cardiovasc Electrophysiol 17:951–956

    Article  PubMed  Google Scholar 

  12. Anderson RH, Webb S, Moorman AF, Brown NA (2004) Morphological correlates of atrial development. John Keith Lecture. Cardiol Young 14:239–254

    Article  PubMed  Google Scholar 

  13. Neill CA (1956) Development of the pulmonary veins; with reference to the embryology of anomalies of pulmonary venous return. Pediatrics 18:880–887

    PubMed  CAS  Google Scholar 

  14. Edwards JE, Dushane JW (1950) Thoracic venous anomalies. Mayo Clin Proc 50:599–600

    Google Scholar 

  15. Haissaguerre M, Jais P, Shah DC et al (1998) Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 339:659–666

    Article  PubMed  CAS  Google Scholar 

  16. Matsuo S, Matsumoto T, Nakae I, Ito M, Horie M (2005) Anomaly of the left atrium in patients with atrial fibrillation detected by ECG-gated multi-slice computed tomography. Int J Cardiovasc Imaging 21:455–458

    Article  PubMed  Google Scholar 

  17. Lickfett L, Kato R, Tandri H et al (2004) Characterization of a new pulmonary vein variant using magnetic resonance angiography: incidence, imaging, and interventional implications of the “right top pulmonary vein”. J Cardiovasc Electrophysiol 15:538–543

    PubMed  Google Scholar 

  18. Vonken EP, Velthuis BK, Wittkampf FH, Rensing BJ, Derksen R, Cramer MJ (2003) Contrast-enhanced MRA and 3D visualization of pulmonary venous anatomy to assist radiofrequency catheter ablation. J Cardiovasc Magn Reson 5:545–551

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Angeline C. Poh, Hale Ersoy, Amanda G. Whitmore, Dimitrios Mitsouras & Frank John Rybicki

  2. Cardiac Registry, Departments of Pathology and Cardiology, Children’s Hospital, Boston, MA, USA

    Amy L. Juraszek

  3. Division of Cardiac Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Michael J. Davidson

Authors
  1. Angeline C. Poh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amy L. Juraszek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hale Ersoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amanda G. Whitmore
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael J. Davidson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dimitrios Mitsouras
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Frank John Rybicki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Frank John Rybicki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Poh, A.C., Juraszek, A.L., Ersoy, H. et al. Endocardial irregularities of the left atrial roof as seen on coronary CT angiography. Int J Cardiovasc Imaging 24, 729–734 (2008). https://doi.org/10.1007/s10554-008-9315-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-008-9315-3

Keywords

Search

Navigation