Cardiac: Atrial fibrillation / arrhythmia

Abstract

CT coronary angiography is an emerging technique able to non-invasively detect significant coronary stenoses and non-obstructive coronary plaques. Promising results have been obtained in selected patients with low (< 70 bpm) and regular heart rates. The introduction of Dual Source CT scanners has resulted in a markedly improved temporal resolution when imaging the small and rapidly moving coronary arteries, which allows improved coronary imaging in patients with higher (> 70 bpm) heart rates. However, the improved temporal resolution of Dual Source CT scanners also allows more reliable evaluation of the coronary arteries in patients with severe heart rhythm irregularities, e.g. patients with atrial fibrillation or frequent premature beats. However, coronary imaging in arrhythmic patients remains challenging: scan protocols must be adapted on a per-patient basis and reconstruction of high quality datasets requires specific skills of the radiographer and / or radiologist. In this chapter, we will discuss tips & tricks to improve image quality in patients with severe arrhythmia, and we will present two cases of patients with atrial fibrillation and symptoms of atypical chest pain and chronic stable angina pectoris. © 2008 Springer Medizin Verlag Heidelberg.