In the last decade, there has been increasing evidence that comprehensive evaluation of the left atrium is of utmost importance. Numerous studies have clearly demonstrated the prognostic value of left atrial volume for long-term outcome. Furthermore, advances in catheter ablation procedures used for the treatment of drug-refractory atrial fibrillation require the need for detailed knowledge of left atrial and pulmonary venous morphology as well of atrial wall characteristics. This review article discusses the role of cardiac magnetic resonance and computed tomography in assessment of left atrial size, its normal and abnormal morphology, and function. Special interest is paid to the utility of these rapidly involving noninvasive imaging methods before and after atrial fibrillation ablation.

2nd Department of Medicine Department of Cardiovascular Medicine 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Prague Czech Republic

2nd Department of Medicine Department of Cardiovascular Medicine 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Prague Czech Republic ; International Clinical Research Center St Anne's University Hospital in Brno Brno Czech Republic

Department of Radiology 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Prague Czech Republic

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Hoit B. D. Left atrial size and function: role in prognosis. Journal of the American College of Cardiology. 2014;63(6):493–505. doi: 10.1016/j.jacc.2013.10.055. PubMed DOI

Rahimtoola S. H., Ehsani A., Sinno M. Z., Loeb H. S., Rosen K. M., Gunnar R. M. Left atrial transport function in myocardial infarction. Importance of its booster pump function. The American Journal of Medicine. 1975;59(5):686–694. doi: 10.1016/0002-9343(75)90229-6. PubMed DOI

Tsang T. S. M., Barnes M. E., Bailey K. R., et al. Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women. Mayo Clinic Proceedings. 2001;76(5):467–475. doi: 10.4065/76.5.467. PubMed DOI

Barnes M. E., Miyasaka Y., Seward J. B., et al. Left atrial volume in the prediction of first ischemic stroke in an elderly cohort without atrial fibrillation. Mayo Clinic Proceedings. 2004;79(8):1008–1014. doi: 10.4065/79.8.1008. PubMed DOI

Osranek M., Bursi F., Bailey K. R., et al. Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up. European Heart Journal. 2005;26(23):2556–2561. doi: 10.1093/eurheartj/ehi483. PubMed DOI

Tsang T. S. M., Abhayaratna W. P., Barnes M. E., et al. Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter? Journal of the American College of Cardiology. 2006;47(5):1018–1023. doi: 10.1016/j.jacc.2005.08.077. PubMed DOI

MacEira A. M., Cosín-Sales J., Roughton M., Prasad S. K., Pennell D. J. Reference left atrial dimensions and volumes by steady state free precession cardiovascular magnetic resonance. Journal of Cardiovascular Magnetic Resonance. 2010;12(1, article 65) doi: 10.1186/1532-429x-12-65. PubMed DOI PMC

To A. C. Y., Flamm S. D., Marwick T. H., Klein A. L. Clinical utility of multimodality la imaging: assessment of size, function, and structure. JACC: Cardiovascular Imaging. 2011;4(7):788–798. doi: 10.1016/j.jcmg.2011.02.018. PubMed DOI

Haemers P., Claus P., Willems R. The use of cardiac magnetic resonance imaging in the diagnostic workup and treatment of atrial fibrillation. Cardiology Research and Practice. 2012;2012:6. doi: 10.1155/2012/658937.658937 PubMed DOI PMC

Pazos-López P., Pozo E., Siqueira M. E., et al. Value of CMR for the differential diagnosis of cardiac masses. JACC Cardiovasc Imaging. 2014;7(9):896–905. doi: 10.1016/j.jcmg.2014.05.009. PubMed DOI

Braggion-Santos M. F., Koenigkam-Santos M., Teixeira S. R., Volpe G. J., Trad H. S., Schmidt A. Magnetic resonance imaging evaluation of cardiac masses. Arquivos Brasileiros de Cardiologia. 2013;101(3):263–272. doi: 10.5935/abc.20130150. PubMed DOI PMC

Matsuda M., Matsuda Y. Mechanism of left atrial enlargement related to ventricular diastolic impairment in hypertension. Clinical Cardiology. 1996;19(12):954–959. doi: 10.1002/clc.4960191211. PubMed DOI

Modena M. G., Muia N., Jr., Sgura F. A., Molinari R., Castelli A., Rossi R. Left atrial size is the major predictor of cardiac death and overall clinical outcome in patients with dilated cardiomyopathy: a long term follow up study. Clinical Cardiology. 1997;20(6):553–560. doi: 10.1002/clc.4960200609. PubMed DOI PMC

Benjamin E. J., D'Agostino R. B., Belanger A. J., Wolf P. A., Levy D. Left atrial size and the risk of stroke and death: the Framingham Heart Study. Circulation. 1995;92(4):835–841. doi: 10.1161/01.cir.92.4.835. PubMed DOI

Møller J. E., Hillis G. S., Oh J. K., et al. Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation. 2003;107(17):2207–2212. doi: 10.1161/01.cir.0000066318.21784.43. PubMed DOI

Fatema K., Barnes M. E., Bailey K. R., et al. Minimum vs. maximum left atrial volume for prediction of first atrial fibrillation or flutter in an elderly cohort: a prospective study. European Journal of Echocardiography. 2008;10(2):282–286. doi: 10.1093/ejechocard/jen235. PubMed DOI

Appleton C. P., Galloway J. M., Gonzalez M. S., Gaballa M., Basnight M. A. Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction. Journal of the American College of Cardiology. 1993;22(7):1972–1982. doi: 10.1016/0735-1097(93)90787-2. PubMed DOI

Hoit B. Assessment of echocardiographic left atrial size: how accurate do we need to be? JACC: Cardiovascular Imaging. 2012;5(8):778–780. doi: 10.1016/j.jcmg.2012.06.001. PubMed DOI

Järvinen V. M., Kupari M. M., Hekali P. E., Poutanen V.-P. Right atrial MR imaging studies of cadaveric atrial casts and comparison with right and left atrial volumes and function in healthy subjects. Radiology. 1994;191(1):137–142. doi: 10.1148/radiology.191.1.8134560. PubMed DOI

Agner B. F. R., Kühl J. T., Linde J. J., et al. Assessment of left atrial volume and function in patients with permanent atrial fibrillation: comparison of cardiac magnetic resonance imaging, 320-slice multi-detector computed tomography, and transthoracic echocardiography. European Heart Journal Cardiovascular Imaging. 2014;15(5):532–540. doi: 10.1093/ehjci/jet239. PubMed DOI

McMurray J. J., Adamopoulos S., Anker S. D., Auricchio A., Böhm M. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. European Journal of Heart Failure. 2012;14(8):803–869. PubMed

Gulati A., Ismail T. F., Jabbour A., et al. Clinical utility and prognostic value of left atrial volume assessment by cardiovascular magnetic resonance in non-ischaemic dilated cardiomyopathy. European Journal of Heart Failure. 2013;15(6):660–670. doi: 10.1093/eurjhf/hft019. PubMed DOI

Jahnke C., Fischer J., Mirelis J. G., et al. Cardiovascular magnetic resonance imaging for accurate sizing of the left atrium: predictability of pulmonary vein isolation success in patients with atrial fibrillation. Journal of Magnetic Resonance Imaging. 2011;33(2):455–463. doi: 10.1002/jmri.22426. PubMed DOI

Hudsmith L. E., Petersen S. E., Francis J. M., Robson M. D., Neubauer S. Normal human left and right ventricular and left atrial dimensions using steady state free precession magnetic resonance imaging. Journal of Cardiovascular Magnetic Resonance. 2005;7(5):775–782. doi: 10.1080/10976640500295516. PubMed DOI

Sievers B., Kirchberg S., Franken U., et al. Determination of normal gender-specific left atrial dimensions by cardiovascular magnetic resonance imaging. Journal of Cardiovascular Magnetic Resonance. 2005;7(4):677–683. PubMed

Anderson J. L., Horne B. D., Pennell D. J. Atrial dimensions in health and left ventricular disease using cardiovascular magnetic resonance. Journal of Cardiovascular Magnetic Resonance. 2005;7(4):671–675. doi: 10.1081/JCMR-65617. PubMed DOI

Habibi M., Chahal H., Opdahl A., et al. Association of CMR-measured LA function with heart failure development: results from the MESA study. JACC Cardiovascular Imaging. 2014;7(6):570–579. doi: 10.1016/j.jcmg.2014.01.016. PubMed DOI PMC

Ahtarovski K. A., Iversen K. K., Lønborg J. T., Madsen P. L., Engstrøm T., Vejlstrup N. Left atrial and ventricular function during dobutamine and glycopyrrolate stress in healthy young and elderly as evaluated by cardiac magnetic resonance. The American Journal of Physiology—Heart and Circulatory Physiology. 2012;303(12):H1469–H1473. doi: 10.1152/ajpheart.00365.2012. PubMed DOI

Kaminski M., Steel K., Jerosch-Herold M., et al. Strong cardiovascular prognostic implication of quantitative left atrial contractile function assessed by cardiac magnetic resonance imaging in patients with chronic hypertension. Journal of Cardiovascular Magnetic Resonance. 2011;13:p. 42. doi: 10.1186/1532-429x-13-42. PubMed DOI PMC

Kowallick J. T., Kutty S., Edelmann F., et al. Quantification of left atrial strain and strain rate using Cardiovascular Magnetic Resonance myocardial feature tracking: a feasibility study. Journal of Cardiovascular Magnetic Resonance. 2014;16(1):p. 60. doi: 10.1186/s12968-014-0060-6. PubMed DOI PMC

Ellenbogen K. A., Wood M. A. Ablation of atrial fibrillation: awaiting the new paradigm. Journal of the American College of Cardiology. 2003;42(2):198–200. PubMed

Moore K. L. The Developing Human. Philadelphia, Pa, USA: WB Saunders; 1988.

Pappone C., Santinelli V. Atrial fibrillation ablation: state of the art. The American Journal of Cardiology. 2005;96(12A):59L–64L. PubMed

Calkins H., Reynolds M. R., Spector P., et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circulation: Arrhythmia and Electrophysiology. 2009;2(4):349–361. doi: 10.1161/circep.108.824789. PubMed DOI

Saremi F., Tafti M. The role of computed tomography and magnetic resonance imaging in ablation procedures for treatment of atrial fibrillation. Seminars in Ultrasound, CT and MRI. 2009;30(2):125–156. doi: 10.1053/j.sult.2008.10.015. PubMed DOI

Meng J., Peters D. C., Hsing J. M., et al. Late gadolinium enhancement of the esophagus is common on cardiac MR several months after pulmonary vein isolation: preliminary observations. Pacing and Clinical Electrophysiology. 2010;33(6):661–666. doi: 10.1111/j.1540-8159.2009.02671.x. PubMed DOI

Aljaroudi W. A., Saliba W. S., Wazni O. M., Jaber W. A. Role of cardiac computed tomography and cardiovascular magnetic resonance imaging in guiding management and treatment of patients with atrial fibrillation: state of the art review. Journal of Nuclear Cardiology. 2013;20(3):426–442. doi: 10.1007/s12350-013-9689-z. PubMed DOI

Ohyama H., Hosomi N., Takahashi T., et al. Comparison of magnetic resonance imaging and transesophageal echocardiography in detection of thrombus in the left atrial appendage. Stroke. 2003;34(10):2436–2439. doi: 10.1161/01.str.0000090350.73614.0f. PubMed DOI

Hauser T. H., Peters D. C., Wylie J. V., Manning W. J. Evaluating the left atrium by magnetic resonance imaging. Europace. 2008;10(supplement 3):iii22–iii27. doi: 10.1093/europace/eun223. PubMed DOI PMC

Dill T., Neumann T., Ekinci O., et al. Pulmonary vein diameter reduction after radiofrequency catheter ablation for paroxysmal atrial fibrillation evaluated by contrast-enhanced three-dimensional magnetic resonance imaging. Circulation. 2003;107(6):845–850. doi: 10.1161/01.CIR.0000048146.81336.1D. PubMed DOI

Arentz T., Jander N., von Rosenthal J., et al. Incidence of pulmonary vein stenosis 2 years after radiofrequency catheter ablation of refractory atrial fibrillation. European Heart Journal. 2003;24(10):963–969. doi: 10.1016/s0195-668x(03)00002-2. PubMed DOI

Saad E. B., Rossillo A., Saad C. P., et al. Pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation: functional characterization, evolution, and influence of the ablation strategy. Circulation. 2003;108(25):3102–3107. doi: 10.1161/01.cir.0000104569.96907.7f. PubMed DOI

Kato R., Lickfett L., Meininger G., et al. Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation: lessons learned by use of magnetic resonance imaging. Circulation. 2003;107(15):2004–2010. doi: 10.1161/01.cir.0000061951.81767.4e. PubMed DOI

Hof I., Chilukuri K., Arbab-Zadeh A., et al. Does left atrial volume and pulmonary venous anatomy predict the outcome of catheter ablation of atrial fibrillation? Journal of Cardiovascular Electrophysiology. 2009;20(9):1005–1010. doi: 10.1111/j.1540-8167.2009.01504.x. PubMed DOI

Mulder A. A. W., Wijffels M. C. E. F., Wever E. F. D., Boersma L. V. A. Pulmonary vein anatomy and long-term outcome after multi-electrode pulmonary vein isolation with phased radiofrequency energy for paroxysmal atrial fibrillation. Europace. 2011;13(11):1557–1561. doi: 10.1093/europace/eur236. PubMed DOI

Anselmino M., Scaglione M., Blandino A., et al. Pulmonary veins branching pattern, assessed by magnetic resonance, does not affect transcatheter atrial fibrillation ablation outcome. Acta Cardiologica. 2010;65(6):665–674. PubMed

Schmidt M., Dorwarth U., Straube F., et al. Cryoballoon in AF ablation: impact of PV ovality on AF recurrence. International Journal of Cardiology. 2013;167(1):114–120. doi: 10.1016/j.ijcard.2011.12.017. PubMed DOI

Atwater B. D., Wallace T. W., Kim H. W., et al. Pulmonary vein contraction before and after radiofrequency ablation for atrial fibrillation. Journal of Cardiovascular Electrophysiology. 2011;22(2):169–174. doi: 10.1111/j.1540-8167.2010.01868.x. PubMed DOI

Syed M. A., Peters D. C., Rashid H., Arai A. E. Pulmonary vein imaging: comparison of 3D magnetic resonance angiography with 2D cine MRI for characterizing anatomy and size. Journal of Cardiovascular Magnetic Resonance. 2005;7(2):355–360. doi: 10.1081/jcmr-200053458. PubMed DOI

Daccarett M., McGann C. J., Akoum N. W., MacLeod R. S., Marrouche N. F. MRI of the left atrium: predicting clinical outcomes in patients with atrial fibrillation. Expert Review of Cardiovascular Therapy. 2011;9(1):105–111. doi: 10.1586/erc.10.177. PubMed DOI PMC

Kim R. J., Wu E., Rafael A., et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. The New England Journal of Medicine. 2000;343(20):1445–1453. doi: 10.1056/nejm200011163432003. PubMed DOI

Boudoulas K. D., Paraskevaidis I. A., Boudoulas H., Triposkiadis F. K. The left atrium: from the research laboratory to the clinic. Cardiology. 2014;129(1):1–17. doi: 10.1159/000367907. PubMed DOI

Oakes R. S., Badger T. J., Kholmovski E. G., et al. Detection and quantification of left atrial structural remodeling with delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation. 2009;119(13):1758–1767. doi: 10.1161/CIRCULATIONAHA.108.811877. PubMed DOI PMC

Wylie J. V., Jr., Peters D. C., Essebag V., Manning W. J., Josephson M. E., Hauser T. H. Left atrial function and scar after catheter ablation of atrial fibrillation. Heart Rhythm. 2008;5(5):656–662. doi: 10.1016/j.hrthm.2008.02.008. PubMed DOI

McGann C. J., Kholmovski E. G., Oakes R. S., et al. New magnetic resonance imaging-based method for defining the extent of left atrial wall injury after the ablation of atrial fibrillation. Journal of the American College of Cardiology. 2008;52(15):1263–1271. doi: 10.1016/j.jacc.2008.05.062. PubMed DOI

Arujuna A., Karim R., Caulfield D., et al. Acute pulmonary vein isolation is achieved by a combination of reversible and irreversible atrial injury after catheter ablation: evidence from magnetic resonance imaging. Circulation: Arrhythmia and Electrophysiology. 2012;5(4):691–700. doi: 10.1161/circep.111.966523. PubMed DOI

Badger T. J., Daccarett M., Akoum N. W., et al. Evaluation of left atrial lesions after initial and repeat atrial fibrillation ablation; lessons learned from delayed-enhancement MRI in repeat ablation procedures. Circulation: Arrhythmia and Electrophysiology. 2010;3(3):249–259. doi: 10.1161/circep.109.868356. PubMed DOI PMC

Bertaglia E., Brandolino G., Zoppo F., Zerbo F., Pascotto P. Integration of three-dimensional left atrial magnetic resonance images into a real-time electroanatomic mapping system: validation of a registration method. Pacing and Clinical Electrophysiology. 2008;31(3):273–282. doi: 10.1111/j.1540-8159.2008.00986.x. PubMed DOI

Kistler P. M., Rajappan K., Jahngir M., et al. The impact of CT image integration into an electroanatomic mapping system on clinical outcomes of catheter ablation of atrial fibrillation. Journal of Cardiovascular Electrophysiology. 2006;17(10):1093–1101. doi: 10.1111/j.1540-8167.2006.00594.x. PubMed DOI

Caponi D., Corleto A., Scaglione M., et al. Ablation of atrial fibrillation: does the addition of three-dimensional magnetic resonance imaging of the left atrium to electroanatomic mapping improve the clinical outcome? Europace. 2010;12(8):1098–1104. doi: 10.1093/europace/euq107. PubMed DOI

Abbara S., Arbab-Zadeh A., Callister T. Q., et al. SCCT guidelines for performance of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. Journal of Cardiovascular Computed Tomography. 2009;3(3):190–204. doi: 10.1016/j.jcct.2009.03.004. PubMed DOI

Park M. J., Jung J. I., Oh Y.-S., Youn H.-J. Assessment of the structural remodeling of the left atrium by 64-multislice cardiac CT: comparative studies in controls and patients with atrial fibrillation. International Journal of Cardiology. 2012;159(3):181–186. doi: 10.1016/j.ijcard.2011.02.053. PubMed DOI

Nakamura K., Funabashi N., Uehara M., et al. Left atrial wall thickness in paroxysmal atrial fibrillation by multislice-CT is initial marker of structural remodeling and predictor of transition from paroxysmal to chronic form. International Journal of Cardiology. 2011;148(2):139–147. doi: 10.1016/j.ijcard.2009.10.032. PubMed DOI

Taina M., Korhonen M., Haataja M., et al. Morphological and volumetric analysis of left atrial appendage and left atrium: cardiac computed tomography-based reproducibility assessment. PLoS ONE. 2014;9(7) doi: 10.1371/journal.pone.0101580.e101580 PubMed DOI PMC

Di Biase L., Santangeli P., Anselmino M., et al. Does the left atrial appendage morphology correlate with the risk of stroke in patients with atrial fibrillation? Results from a multicenter study. Journal of the American College of Cardiology. 2012;60(6):531–538. doi: 10.1016/j.jacc.2012.04.032. PubMed DOI

Balli O., Aytemirb K., Karcaaltincabaa M. Multidetector CT of left atrium. European Journal of Radiolog. 2012;81(1):e37–e46. doi: 10.1016/j.ejrad.2010.11.017. PubMed DOI

Shin S. Y., Kwon S. H., Oh J. H. Anatomical analysis of incidental left atrial diverticula in patients with suspected coronary artery disease using 64-channel multidetector CT. Clinical Radiology. 2011;66(10):961–965. doi: 10.1016/j.crad.2011.04.016. PubMed DOI

Incedayi M., Öztürk E., Sönmez G., et al. The incidence of left atrial diverticula in coronary CT angiography. Diagnostic and Interventional Radiology. 2012;18(6):542–546. doi: 10.4261/1305-3825.dir.5388-11.1. PubMed DOI

Benjamin E. J., D'Agostino R. B., Belanger A. J., Wolf P. A., Levy D. Left atrial size and the risk of stroke and death. The Framingham Heart Study. Circulation. 1995;92(4):835–841. doi: 10.1161/01.cir.92.4.835. PubMed DOI

Kizer J. R., Bella J. N., Palmieri V., et al. Left atrial diameter as an independent predictor of first clinical cardiovascular events in middle-aged and elderly adults: the Strong Heart Study (SHS) American Heart Journal. 2006;151(2):412–418. doi: 10.1016/j.ahj.2005.04.031. PubMed DOI

Kühl J. T., Lønborg J., Fuchs A., et al. Assessment of left atrial volume and function: a comparative study between echocardiography, magnetic resonance imaging and multi slice computed tomography. International Journal of Cardiovascular Imaging. 2012;28(5):1061–1071. doi: 10.1007/s10554-011-9930-2. PubMed DOI

Kataoka A., Funabashi N., Takahashi A., et al. Quantitative evaluation of left atrial volumes and ejection fraction by 320-slice computed-tomography in comparison with three- and two-dimensional echocardiography: a single-center retrospective-study in 22 subjects. International Journal of Cardiology. 2011;153(1):47–54. doi: 10.1016/j.ijcard.2010.08.036. PubMed DOI

Wen Z., Zhang Z., Yu W., Fan Z., Du J., Lv B. Assessing the left atrial phasic volume and function with dual-source CT: comparison with 3T MRI. International Journal of Cardiovascular Imaging. 2010;26(supplement 1):83–92. doi: 10.1007/s10554-009-9569-4. PubMed DOI

Rohner A., Brinkert M., Kawel N., et al. Functional assessment of the left atrium by real-time three-dimensional echocardiography using a novel dedicated analysis tool: initial validation studies in comparison with computed tomography. European Journal of Echocardiography. 2011;12(7):497–505. doi: 10.1093/ejechocard/jer066. PubMed DOI

Mahabadi A. A., Geisel M. H., Lehmann N., et al. Association of computed tomography-derived left atrial size with major cardiovascular events in the general population: the Heinz Nixdorf Recall Study. International Journal of Cardiology. 2014;174(2):318–323. doi: 10.1016/j.ijcard.2014.04.068. PubMed DOI

Christiaens L., Varroud-Vial N., Ardilouze P., et al. Real three-dimensional assessment of left atrial and left atrial appendage volumes by 64-slice spiral computed tomography in individuals with or without cardiovascular disease. International Journal of Cardiology. 2010;140(2):189–196. doi: 10.1016/j.ijcard.2008.11.055. PubMed DOI

Mortensen K. H., Gopalan D., Balan A. Atrial masses on multidetector computed tomography. Clinical Radiology. 2013;68(3):e164–e175. doi: 10.1016/j.crad.2012.10.003. PubMed DOI

Wu X., Wang C., Zhang C., Zhang Y., Ding F., Yan J. Computed tomography for detecting left atrial thrombus: a meta-analysis. Archives of Medical Science. 2012;8(6):943–951. doi: 10.5114/aoms.2012.32400. PubMed DOI PMC

Feuchtner G. M., Dichtl W., Bonatti J. O., et al. Diagnostic accuracy of cardiac 64-slice computed tomography in detecting atrial thrombi: comparative study with transesophageal echocardiography and cardiac surgery. Investigative Radiology. 2008;43(11):794–801. doi: 10.1097/rli.0b013e318184cd6c. PubMed DOI

Hur J., Young J. K., Lee H.-J., et al. Left atrial appendage thrombi in stroke patients: detection with two-phase cardiac CT angiography versus transesophageal echocardiography. Radiology. 2009;251(3):683–690. doi: 10.1148/radiol.2513090794. PubMed DOI

Hur J., Kim Y. J., Lee H.-J., et al. Dual-enhanced cardiac CT for detection of left atrial appendage thrombus in patients with stroke: a prospective comparison study with transesophageal echocardiography. Stroke. 2011;42(9):2471–2477. doi: 10.1161/strokeaha.110.611293. PubMed DOI

Hur J., Pak H.-N., Kim Y. J., et al. Dual-enhancement cardiac computed tomography for assessing left atrial thrombus and pulmonary veins before radiofrequency catheter ablation for atrial fibrillation. The American Journal of Cardiology. 2013;112(2):238–244. doi: 10.1016/j.amjcard.2013.03.018. PubMed DOI

Marom E. M., Herndon J. E., Kim Y. H., McAdams H. P. Variations in pulmonary venous drainage to the left atrium: implications for radiofrequency ablation. Radiology. 2004;230(3):824–829. doi: 10.1148/radiol.2303030315. PubMed DOI

Tops L. F., van der Wall E. E., Schalij M. J., Bax J. J. Multi-modality imaging to assess left atrial size, anatomy and function. Heart. 2007;93(11):1461–1470. doi: 10.1136/hrt.2007.116467. PubMed DOI PMC

Kim Y.-H., Marom E. M., Herndon J. E., II, McAdams H. P. Pulmonary vein diameter, cross-sectional area, and shape: CT analysis. Radiology. 2005;235(1):43–49. doi: 10.1148/radiol.2351032106. PubMed DOI

Packer D. L., Keelan P., Munger T. M., et al. Clinical presentation, investigation, and management of pulmonary vein stenosis complicating ablation for atrial fibrillation. Circulation. 2005;111(5):546–554. doi: 10.1161/01.CIR.0000154541.58478.36. PubMed DOI

Holmes D. R., Jr., Monahan K. H., Packer D. Pulmonary vein stenosis complicating ablation for atrial fibrillation: clinical spectrum and interventional considerations. JACC: Cardiovascular Interventions. 2009;2(4):267–276. doi: 10.1016/j.jcin.2008.12.014. PubMed DOI

Pürerfellner H., Martinek M. Pulmonary vein stenosis following catheter ablation of atrial fibrillation. Current Opinion in Cardiology. 2005;20(6):484–490. doi: 10.1097/01.hco.0000179816.80576.3c. PubMed DOI