BACKGROUND: Atrial fibrillation (AF) presents a potential challenge when performing coronary computed tomography angiography (CTA). To date, there is no ideal protocol for CTA in patients with AF. We sought to design a protocol for single-heartbeat coronary CTA in patients with AF. METHODS: We enrolled 32 patients with AF and a very low probability of coronary artery disease who were referred for CTA to assess pulmonary vein anatomy for catheter ablation. A 256-slice scanner was used. Twelve patients underwent CTA using non-gated triple Flash (NGTF) consisting of three prospective electrocardiogram (ECG)-triggered helical scans with a built-in ECG simulator, while retrospectively gated helical (RGH) was used in 20 patients. Radiation dose, and a 4-point scale was used to assess coronary artery image quality between CTA scan modes. RESULTS: A total of 96 vessels were analyzed. The 4-point score showed no significant differences between the RGH and NGTF scans (2.9 ± 0.6 vs. 2.8 ± 0.8, respectively; p = 0.34). The number of coronary arteries with extensive blurring did not significantly differ between the protocols, and included four vessels (6.6%) in RGH vs. three vessels (8.3%) in NGTF (p = 0.5). Radiation exposure was significantly higher with RGH scans, with a dose-length product of 835 ± 146 mGy compared with 382 ± 35 mGy for NGTF (p < 0.0001). CONCLUSIONS: Single heartbeat NGTF CTA has comparable image quality and significantly lower radiation dose compared to RGH scans in patients with AF. Whether this protocol can be used in next-generation computed tomography scanners has yet to be determined.
BACKGROUND: Atrial fibrillation (AF) presents a potential challenge when performing coronary computed tomography angiography (CTA). To date, there is no ideal protocol for CTA in patients with AF. We sought to design a protocol for single-heartbeat coronary CTA in patients with AF. METHODS: We enrolled 32 patients with AF and a very low probability of coronary artery disease who were referred for CTA to assess pulmonary vein anatomy for catheter ablation. A 256-slice scanner was used. Twelve patients underwent CTA using non-gated triple Flash (NGTF) consisting of three prospective electrocardiogram (ECG)-triggered helical scans with a built-in ECG simulator, while retrospectively gated helical (RGH) was used in 20 patients. Radiation dose, and a 4-point scale was used to assess coronary artery image quality between CTA scan modes. RESULTS: A total of 96 vessels were analyzed. The 4-point score showed no significant differences between the RGH and NGTF scans (2.9 ± 0.6 vs. 2.8 ± 0.8, respectively; p = 0.34). The number of coronary arteries with extensive blurring did not significantly differ between the protocols, and included four vessels (6.6%) in RGH vs. three vessels (8.3%) in NGTF (p = 0.5). Radiation exposure was significantly higher with RGH scans, with a dose-length product of 835 ± 146 mGy compared with 382 ± 35 mGy for NGTF (p < 0.0001). CONCLUSIONS: Single heartbeat NGTF CTA has comparable image quality and significantly lower radiation dose compared to RGH scans in patients with AF. Whether this protocol can be used in next-generation computed tomography scanners has yet to be determined.
Authors: Allen J Taylor; Manuel Cerqueira; John McB Hodgson; Daniel Mark; James Min; Patrick O'Gara; Geoffrey D Rubin; Christopher M Kramer; Daniel Berman; Alan Brown; Farooq A Chaudhry; Ricardo C Cury; Milind Y Desai; Andrew J Einstein; Antoinette S Gomes; Robert Harrington; Udo Hoffmann; Rahul Khare; John Lesser; Christopher McGann; Alan Rosenberg; Robert Schwartz; Marc Shelton; Gerald W Smetana; Sidney C Smith Journal: J Am Coll Cardiol Date: 2010-11-23 Impact factor: 24.094
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Authors: Jörg Hausleiter; Tanja S Meyer; Eugenio Martuscelli; Pietro Spagnolo; Hiroaki Yamamoto; Patricia Carrascosa; Thomas Anger; Lukas Lehmkuhl; Hatem Alkadhi; Stefan Martinoff; Martin Hadamitzky; Franziska Hein; Bernhard Bischoff; Miriam Kuse; Albert Schömig; Stephan Achenbach Journal: JACC Cardiovasc Imaging Date: 2012-05
Authors: Tust Techasith; Brian B Ghoshhajra; Quynh A Truong; Rodrigo Pale; Khurram Nasir; Michael A Bolen; Udo Hoffmann; Ricardo C Cury; Suhny Abbara; Thomas J Brady; Ron Blankstein Journal: J Cardiovasc Comput Tomogr Date: 2011-05-25
Authors: Gilbert L Raff; Kavitha M Chinnaiyan; Ricardo C Cury; Mario T Garcia; Harvey S Hecht; Judd E Hollander; Brian O'Neil; Allen J Taylor; Udo Hoffmann Journal: J Cardiovasc Comput Tomogr Date: 2014-06-12