title: Image-guided optimization of the ECG trace in cardiac MRI.
abstract: Improper electrocardiogram (ECG) lead placement resulting in suboptimal gating may lead to reduced image quality in cardiac magnetic resonance imaging (CMR). A patientspecific systematic technique for rapid optimization of lead placement may improve CMR image quality. A rapid 3 dimensional image of the thorax was used to guide the realignment of ECG leads relative to the cardiac axis of the patient in forty consecutive adult patients. Using our novel approach and consensus reading of pre- and post-correction ECG traces, seventy-three percent of patients had a qualitative improvement in their ECG tracings, and no patient had a decrease in quality of their ECG tracing following the correction technique. Statistically significant improvement was observed independent of gender, body mass index, and cardiac rhythm. This technique provides an efficient option to improve the quality of the ECG tracing in patients who have a poor quality ECG with standard techniques.
authors.affiliation: UNC School of Medicine, 1001 Bondurant Hall, CB 9535, Attention Mail Box 404, Chapel Hill, NC 27599-9535, USA. james_barnwell@med.unc.edu
authors.forename: James D
authors.initials: JD
authors.lastname: Barnwell
authors.forename: J Larry
authors.initials: JL
authors.lastname: Klein
authors.forename: Cliff
authors.initials: C
authors.lastname: Stallings
authors.forename: Amanda
authors.initials: A
authors.lastname: Sturm
authors.forename: Michael
authors.initials: M
authors.lastname: Gillespie
authors.forename: Jason
authors.initials: J
authors.lastname: Fine
authors.forename: W Brian
authors.initials: WB
authors.lastname: Hyslop
mesh_terms: D000328:Adult; D000368:Aged; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D015588:Observer Variation; D050177:Overweight / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results