Imaging of pulmonary vein anatomy using low-dose prospective ECG-triggered dual-source computed tomography
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To prospectively investigate the feasibility, image quality and radiation dose estimates for computed tomography angiography (CTA) of the pulmonary veins and left atrium using prospective electrocardiography (ECG)-triggered sequential dual-source (DS) data acquisition at end-systole in patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation.
Thirty-five patients (mean age 66.2 ± 12.6 years) with paroxysmal atrial fibrillation underwent prospective ECG-triggered sequential DS-CTA with tube current (250 mAs/rotation) centred 250 ms past the R-peak. Tube voltage was adjusted to the BMI (<25 kg/m2: 100 kV, >25 kg/m2: 120 kV). Presence of motion or stair-step artefacts was assessed. Effective radiation dose was calculated from the dose-length product.
All data sets could be integrated into the electroanatomical mapping system. Twenty-two patients (63%) were in sinus rhythm (mean heart rate 69.2 ± 11.1 bpm, variability 1.0 ± 1.7 bpm) and 13 (37%) showed an ECG pattern of atrial fibrillation (mean heart rate 84.8 ± 16.6 bpm, variability 17.9 ± 7.5 bpm). Minor step artefacts were observed in three patients (23%) with atrial fibrillation. Mean estimated effective dose was 1.1 ± 0.3 and 3.0 ± 0.5 mSv for 100 and 120 kV respectively.
Imaging of pulmonary vein anatomy is feasible using prospective ECG-triggered sequential data acquisition at end-systole regardless of heart rate or rhythm at the benefit of low radiation dose.
KeywordsDual-source CT Pulmonary vein anatomy Pulmonary vein isolation Atrial fibrillation Prospective ECG triggering
- 1.Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al (2006) ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114:e257–e354CrossRefPubMedGoogle Scholar
- 8.Menzel H, Schibilla H, Teunen D et al (2000) European guidelines on quality criteria for computed tomography. Publication no. EUR 16262 EN. European Commission, LuxembourgGoogle Scholar