The presence of endocardial leads may limit applicability of coronary CT angiography.
OBJECTIVE
Some indications that MSCT is necessary may be visible in patients with implanted pacemakers, CRTs and ICDs devices. Purpose. To evaluate whether the presence of endocardial leads influences the quality of visualization of the coronary arteries in MSCT.


METHODS
In 37 patients a 64-slice MSCT (Aquilion 64, Toshiba) was performed due to a suspicion of ischemic heart disease (33 patients) or suspicion of lead perforation (four patients). The control group consists of 35 patients. Influence of the leads was evaluated independently by two cardiologists.


RESULTS
The total number of leads that were evaluated was 63. In 26 cases (41%) significant problems with the evaluation of coronary arteries occurred: LM-1 (2%) case, LAD-3 (5%) cases, LCx-4 (6%) cases, RCA-18 (28%) cases. The presence of a right ventricular lead did not influence the quality of the imaging of the left main coronary artery (LM) and its main branches (LAD and LCx). The main concerns were related to the RCA visualization-interpretable images in 18/63 (29%) of the analyzed leads.


CONCLUSIONS
The presence of implanted endocardial leads may limit the applicability of coronary CT angiography in patients with implanted anti-arrhythmic devices.
Sosnowski
Maciej
M
Unit of Noninvasive Cardiovascular Diagnostics, Medical University of Silesia, Upper-Silesian Cardiology Center, Katowice, Poland.
Mlynarski
Rafal
R
Wlodyka
Agnieszka
A
Brzoska
Jan
J
Kargul
Wlodzimierz
W
Tendera
Michal
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D002304:Cardiac Pacing, Artificial; D016022:Case-Control Studies; D017023:Coronary Angiography / Q000379:methods*; D017147:Defibrillators, Implantable / Q000009:adverse effects; D004554:Electric Countershock / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D015588:Observer Variation; D010138:Pacemaker, Artificial / Q000009:adverse effects; D011044:Poland; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed