Early Evaluation of Left Atrial Appendage With Cardiac Computed Tomography to Reduce Health Care Utilization
- 1Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Abstract
Background: Transesophageal echocardiography (TEE) is routinely used to exclude left atrial appendage thrombus before direct current cardioversion (DCCV) in atrial fibrillation/atrial flutter but is invasive and limited by procedural availability. Cardiac computed tomography (CCT) offers a noninvasive alternative.
Project Rationale: Limited access to TEE may delay DCCV and prolong hospital length of stay (LOS). We hypothesized that an early CCT-guided pathway would reduce time to cardioversion and LOS.
Project Summary: Adult patients hospitalized with atrial fibrillation/atrial flutter underwent CCT-guided evaluation. Twenty-two patients were included across 2 plan-do-study-act cycles. Mean time-to-DCCV was 0.75 and 1.0 days, with LOS of 3.9 and 4.6 days, respectively. No acute kidney injury or anesthesia-related complications occurred. Compared with a historical TEE-guided cohort (n = 278), CCT was associated with shorter time-to-DCCV (3.8 days) and LOS (6.3 days).
Take-Home Message: Early, standardized use of CCT is feasible, safe, and reduces treatment delays.
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BibTeX
@article{zheng2026early,
title = {{Early Evaluation of Left Atrial Appendage With Cardiac Computed Tomography to Reduce Health Care Utilization}},
author = {Lillian Zheng and Divyanshu Mohananey and Victor Redmon},
journal = {JACC Case Reports},
year = {2026},
month = sep,
doi = {10.1016/j.jaccas.2026.109523},
url = {https://doi.org/10.1016/j.jaccas.2026.109523},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Early Evaluation of Left Atrial Appendage With Cardiac Computed Tomography to Reduce Health Care Utilization
AU - Lillian Zheng
AU - Divyanshu Mohananey
AU - Victor Redmon
PY - 2026
DA - 2026/09/16
JO - JACC Case Reports
DO - 10.1016/j.jaccas.2026.109523
UR - https://doi.org/10.1016/j.jaccas.2026.109523
AB - Background: Transesophageal echocardiography (TEE) is routinely used to exclude left atrial appendage thrombus before direct current cardioversion (DCCV) in atrial fibrillation/atrial flutter but is invasive and limited by procedural availability. Cardiac computed tomography (CCT) offers a noninvasive alternative. Project Rationale: Limited access to TEE may delay DCCV and prolong hospital length of stay (LOS). We hypothesized that an early CCT-guided pathway would reduce time to cardioversion and LOS. Project Summary: Adult patients hospitalized with atrial fibrillation/atrial flutter underwent CCT-guided evaluation. Twenty-two patients were included across 2 plan-do-study-act cycles. Mean time-to-DCCV was 0.75 and 1.0 days, with LOS of 3.9 and 4.6 days, respectively. No acute kidney injury or anesthesia-related complications occurred. Compared with a historical TEE-guided cohort (n = 278), CCT was associated with shorter time-to-DCCV (3.8 days) and LOS (6.3 days). Take-Home Message: Early, standardized use of CCT is feasible, safe, and reduces treatment delays.
SN - 2666-0849
ER -