Le scanner pré-ablation de fibrillation auriculaire est une opportunité pour dépister la maladie coronaire

Abstract

Atrial fibrillation is a frequent and potentially severe cardiovascular disease. Pulmonary vein isolation by radiofrequency is a common and increasing treatment. Pre-ablation cardiac CT-scan allows the screening for anomalous pulmonary venous return or for thrombus in the left atrial appendage. Moreover, it permits a complete three-dimensional left atrial mapping before the ablation, complementary to the electric mapping. But this acquisition also allows coronary artery analysis if the heart rhythm is controlled. The visualization of the coronary arteries permits the detection of obstructive coronary disease leading to revascularisation, thus lowering the anaesthesia risk during pulmonary vein isolation procedure but also allows the diagnostic of early and moderate stages of coronary atherosclerosis, guiding the preventive therapies thus improving the patient’s outcomes. Coronary analysis should be a constant goal while performing pre-ablation cardiac CT-scan.