CTICasesLeft Atrial Endocardial Calcification following Radiofrequency Catheter Ablation
Imaging findings
Chest CT demonstrates tiny, highly localized, focal calcifications along the endocardial surface of the left atrium. These calcified foci are located near the roof of the left atrium and the ostium of the left inferior pulmonary vein. The left atrium is otherwise normal in caliber, and the mitral valve is normal, without features of mitral stenosis, porcelain left atrium, or systemic metabolic calcification.
Key takeaways
Radiofrequency catheter ablation for atrial fibrillation can lead to localized thermal injury, scarring, and subsequent dystrophic endocardial calcification at the ablation sites, particularly near the pulmonary vein ostia. Unlike diffuse calcification seen in porcelain left atrium (typically secondary to chronic mitral stenosis or end-stage renal disease), post-ablation calcifications are highly focal, discrete, and clinically asymptomatic, representing a benign post-procedural finding that should not be misinterpreted.
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