Incidental extracardiac findings on pre-ablation computed tomography angiography in atrial fibrillation patients: a single-center retrospective study

Abstract Background Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with significant complications and is increasingly common due to an aging population. Computed tomography angiography (CTA) is a non-invasive imaging technique that offers detailed insights into cardiac and extracardiac anatomical structures, making it particularly valuable for evaluating patients prior to AF catheter ablation. Purpose This study aimed to assess the prevalence and management of extracardiac findings (ECFs) identified during CTA performed before AF catheter ablation. Methods This single-center, retrospective study reviewed the cases of 163 patients who underwent AF catheter ablation between January 2021 and January 2022. From the 163 patients screened, 140 (85.88%) underwent CTA. Clinical information, including past medical history, cardiovascular risk factors, comorbidities, echocardiogram results, and coronary artery angiography findings, was compiled. All CTA scans were evaluated for ECFs, which were deemed clinically significant only if further investigations were warranted following their detection. Results Out of the 140 patients who underwent CTA, 52 (35.8%) had incidental ECFs including lung nodules, infiltrates, masses, thoracic aortic aneurysms, mediastinal nodes, abdominal masses, and liver nodules. There were no significant demographic differences between the overall group and those who received CTA, with a mean age of 62 ± 10 years. The average CHA2DS2-VASc score was 2.3 ± 1.4. The majority of ECFs were found in the thoracic region. Notably, 1.4% of patients had to postpone their ablation procedures due to ECFs Conclusion CTA serves as a vital tool for assessing cardiac and noncardiac structures, emphasizing the importance of collaborative efforts between radiologists and cardiologists for appropriate management and patient care.Graphical Abstract