title: Imaging of pulmonary vein anatomy using low-dose prospective ECG-triggered dual-source computed tomography.
abstract: OBJECTIVE
  To prospectively investigate the feasibility, image quality and radiation dose estimates for computed tomography angiography (CTA) of the pulmonary veins and left atrium using prospective electrocardiography (ECG)-triggered sequential dual-source (DS) data acquisition at end-systole in patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation.
  
  
  METHODS
  Thirty-five patients (mean age 66.2 +/- 12.6 years) with paroxysmal atrial fibrillation underwent prospective ECG-triggered sequential DS-CTA with tube current (250 mAs/rotation) centred 250 ms past the R-peak. Tube voltage was adjusted to the BMI (<25 kg/m(2): 100 kV, >25 kg/m(2): 120 kV). Presence of motion or stair-step artefacts was assessed. Effective radiation dose was calculated from the dose-length product.
  
  
  RESULTS
  All data sets could be integrated into the electroanatomical mapping system. Twenty-two patients (63%) were in sinus rhythm (mean heart rate 69.2 +/- 11.1 bpm, variability 1.0 +/- 1.7 bpm) and 13 (37%) showed an ECG pattern of atrial fibrillation (mean heart rate 84.8 +/- 16.6 bpm, variability 17.9 +/- 7.5 bpm). Minor step artefacts were observed in three patients (23%) with atrial fibrillation. Mean estimated effective dose was 1.1 +/- 0.3 and 3.0 +/- 0.5 mSv for 100 and 120 kV respectively.
  
  
  CONCLUSIONS
  Imaging of pulmonary vein anatomy is feasible using prospective ECG-triggered sequential data acquisition at end-systole regardless of heart rate or rhythm at the benefit of low radiation dose.
authors.affiliation: Department of Diagnostic Radiology, University Hospital Freiburg, Freiburg, Germany. philipp.blanke@uniklinik-freiburg.de
authors.forename: Philipp
authors.initials: P
authors.lastname: Blanke
authors.forename: Tobias
authors.initials: T
authors.lastname: Baumann
authors.forename: Mathias
authors.initials: M
authors.lastname: Langer
authors.forename: Gregor
authors.initials: G
authors.lastname: Pache
mesh_terms: D000368:Aged; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D010690:Phlebography / Q000379:methods*; D011667:Pulmonary Veins / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*