Left atrial volume by cardiac CTA prior to catheter ablation: comparison to echocardiography and association with recurrent atrial fibrillation

Fig. 1. Comparison of computed tomography and echocardiography LA volume measurements obtained from the same patient with atrial fibrillation undergoing evaluation for pulmonary vein isolation procedure. A, Computed tomographic 4-chamber reconstruction at the maximal LA basal and longitudinal dimensions. B, Computed tomographic 2-chamber reconstruction at the maximal LA basal and longitudinal dimensions. A and B show LA volume measurement by the CT area-length method. C, Echocardiographic 4-chamber view. D, Echocardiographic 2-chamber view. C and D show LA volume measurement by echocardiographic area-length method. The inherent challenges of echocardiography, including adequate visualization of the LA, foreshortening and tracing difficulties are demonstrated

Fig. 2. Bland Altman Plot for echocardiography and CCTA values. CCTA LAVI is systematically greater than echocardiographic LAVI (p < 0.001) via paired samples t test. The slope is significant (p < 0.001) indicating a greater divergence with larger LAVI values

Fig. 3. Area under the curve values for CCTA LAVI ≥ 55 ml/m2 and echocardiographic LAVI ≥ 34 ml/m2. A, CCTA LAVI ≥ 55 ml/m2, AUC 0.689 ± 0.065 (95% CI 0.563–0.816), P = 0.007 and sensitivity = 71%, 1-Specificity = 33%. B, Echocardiographic LAVI ≥ 34 ml/m2, AUC 0.579 ± 0.071 (95% CI 0.440–0.718), P = 0.256

Fig. 4. Study summary. This figure highlights area-length method used during this study for LAVI measurements in patients with AF prior to undergoing PVI and summarizes key findings