Prevalence and Clinical Relevance of Extracardiac Findings on Preprocedural Computed Tomography Angiography for Catheter Ablation of Atrial Fibrillation

Objectives: Atrial fibrillation (AF), a common cardiac arrhythmia with significant stroke risk, is expected to increase in prevalence with an ageing population.Cardiac computed tomography angiography (CCTA) is a non-invasive imaging modality that provides detailed cardiac and extracardiac anatomical information, particularly relevant for preprocedural assessment of AF catheter ablation.This study aimed to determine the prevalence of extracardiac findings (ECFs) during CCTA performed prior to AF catheter ablation. Materials and Methods:This retrospective single-center study reviewed data from 163 patients with AF who underwent catheter ablation between January 2021 and January 2022.Among the 163 patients, 140 (85.88%)underwent preprocedural CCTA.ECFs were defined as newly detected findings necessitating follow-up, diagnostic workup, or therapeutic measures, excluding known abnormalities and clinically nonsignificant findings.Results: Out of the 140 patients who underwent CCTA, 50 patients (35.7%) had 52 incidental ECF.Pulmonary findings were the most common, including pulmonary nodules (>6 mm) in 20 patients (14.2%), pulmonary infiltrates in 8 patients (5.71%), and a pulmonary mass in 1 patient (0.71%).Other significant findings included aortic aneurysms in 3 patients (2.13%), enlarged mediastinal lymph nodes in 8 patients (5.71%), abdominal mass in 1 patient (0.71%), and unclear liver lesions in 5 patients (3.55%).Two incidental findings led to the postponement of the AF catheter ablation procedure.