AIMS: Rotational angiography with digital three-dimensional reconstruction (3DRA) allows per-procedural 3D imaging to facilitate cardiac ablation procedures. We developed a new approach that allows per-procedural 3D imaging of the atria and ventricles with a single C-arm rotation, combining higher 3D image quality with a lower contrast and radiation dose. METHODS AND RESULTS: Forty patients underwent 3DRA of the left atrium (LA, n = 26), right atrium (RA, n = 11), left ventricle (LV, n = 2), or right ventricle (RV, n = 1) during ablation procedures performed under general anaesthesia. Contrast agent (60 +/- 12 mL) was diluted and injected directly in the chamber of interest, during adenosine-induced ventricular asystole (n = 31) or rapid RV pacing (n = 9, atrial imaging only) to reduce cardiac motion artefacts and enhance contrast opacification during rotational imaging. Reconstructed 3D data sets were graded according to predefined quality criteria (n = 40) and quantitatively compared with cardiac computed tomography (CT) (LA, n = 14). Adenosine-induced ventricular asystole and rapid pacing both allowed a sustained and homogeneous contrast opacification of target cardiac chambers, resulting in useful 3D data sets in 39 of 40 (98%) patients. Moreover, it was possible to achieve 'good' or 'optimal' 3D image quality in the majority of patients (adenosine: 61%, pacing 78%, P = 0.69). When compared with rapid pacing, the total elimination of cardiac motion artefacts with adenosine more frequently resulted in 'optimal' 3D image quality (42% vs. 11%, P = 0.01) and added the possibility for single-rotation 3D imaging of the ventricles. Quantitative analysis showed an excellent agreement between pulmonary vein diameters measured on cardiac CT and 3DRA images. Integration of 3DRA-based LA surfaces with real-time fluoroscopy was easy and highly accurate. CONCLUSION: Adenosine-induced ventricular asystole or rapid ventricular pacing allow acquisition of 3DRA with an excellent direct contrast opacification of any cardiac chamber and a reduction of cardiac motion artefacts, resulting in high-quality per-procedural 3D imaging with a single C-arm rotation.
AIMS: Rotational angiography with digital three-dimensional reconstruction (3DRA) allows per-procedural 3D imaging to facilitate cardiac ablation procedures. We developed a new approach that allows per-procedural 3D imaging of the atria and ventricles with a single C-arm rotation, combining higher 3D image quality with a lower contrast and radiation dose. METHODS AND RESULTS: Forty patients underwent 3DRA of the left atrium (LA, n = 26), right atrium (RA, n = 11), left ventricle (LV, n = 2), or right ventricle (RV, n = 1) during ablation procedures performed under general anaesthesia. Contrast agent (60 +/- 12 mL) was diluted and injected directly in the chamber of interest, during adenosine-induced ventricular asystole (n = 31) or rapid RV pacing (n = 9, atrial imaging only) to reduce cardiac motion artefacts and enhance contrast opacification during rotational imaging. Reconstructed 3D data sets were graded according to predefined quality criteria (n = 40) and quantitatively compared with cardiac computed tomography (CT) (LA, n = 14). Adenosine-induced ventricular asystole and rapid pacing both allowed a sustained and homogeneous contrast opacification of target cardiac chambers, resulting in useful 3D data sets in 39 of 40 (98%) patients. Moreover, it was possible to achieve 'good' or 'optimal' 3D image quality in the majority of patients (adenosine: 61%, pacing 78%, P = 0.69). When compared with rapid pacing, the total elimination of cardiac motion artefacts with adenosine more frequently resulted in 'optimal' 3D image quality (42% vs. 11%, P = 0.01) and added the possibility for single-rotation 3D imaging of the ventricles. Quantitative analysis showed an excellent agreement between pulmonary vein diameters measured on cardiac CT and 3DRA images. Integration of 3DRA-based LA surfaces with real-time fluoroscopy was easy and highly accurate. CONCLUSION:Adenosine-induced ventricular asystole or rapid ventricular pacing allow acquisition of 3DRA with an excellent direct contrast opacification of any cardiac chamber and a reduction of cardiac motion artefacts, resulting in high-quality per-procedural 3D imaging with a single C-arm rotation.
Authors: Sebastian Hilbert; Nikolaos Dagres; Gerhard Hindricks; Philipp Sommer; Thomas Gaspar; Loukianos S Rallidis; Dimitrios Th Kremastinos; Christopher Piorkowski Journal: Heart Vessels Date: 2010-10-21 Impact factor: 2.037
Authors: Jonathan G Schwartz; Anne M Neubauer; Thomas E Fagan; Niels J Noordhoek; Michael Grass; John D Carroll Journal: Int J Cardiovasc Imaging Date: 2011-03-11 Impact factor: 2.357
Authors: Teresa Strisciuglio; Giuseppe Di Gioia; Sofia Chatzikyriakou; Etel Silva Garcia; Emanuele Barbato; Peter Geelen; Tom De Potter Journal: Int J Cardiovasc Imaging Date: 2017-09-16 Impact factor: 2.357
Authors: B Patel; Jc Coyle; E Poe; C Rosenbloom; Rm Stevens; Js Coren; S Ge; Ic Mesia; A Moulick; A Toib Journal: Images Paediatr Cardiol Date: 2013-01