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Advanced Adaptive Axial-Sequential Prospectively Electrocardiogram-Triggered Dual-Source Coronary Computed Tomographic Angiography in a Patient With Atrial Fibrillation

Sidhu, Manavjot S. MD; Venkatesh, Vikram MD; Hoffmann, Udo MD, MPH; Ghoshhajra, Brian B. MD, MBA

Journal of Computer Assisted Tomography: November/December 2011 - Volume 35 - Issue 6 - p 747–748
doi: 10.1097/RCT.0b013e3182355960
Case Report

Atrial fibrillation is considered a relative contraindication to coronary computed tomographic angiography (CCTA) because image quality and radiation dose-saving measures largely depend on low and stable heart rates. Most published experiences with CCTA during atrial fibrillation have relied on retrospective gating to mitigate artifacts via electrocardiogram editing. However, a large number of patients arrive at the CT suite with irregular heart rates. We present a case in which we used a prospectively electrocardiogram-triggered axial-sequential scan mode with a novel arrhythmia protection algorithm to obtain motion-free, high-quality CCTA images at a low radiation dose.

From the Department of Cardiovascular Imaging, Cardiac MR PET CT Program, Department of Radiology and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Received for publication August 11, 2011; accepted August 23, 2011.

Reprints: Manavjot S. Sidhu, MD, Clinical and Research Fellow, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge St, Suite 400, Boston, MA, 02114 (e-mail:

No funding/support was received for this work.

The authors report no conflicts of interest.

© 2011 Lippincott Williams & Wilkins, Inc.