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Role of low kilovoltage electrocardiographic-gated multidetector CT in electrophysiological procedures in the paediatric age group

  • Sameh N. K. Khalil (a1) and Ahmed S. Ibrahim (a1)

Abstract

Treatment of arrhythmias by catheter ablation targeting the anatomical foci of arrhythmias by radiofrequency has evolved dramatically in recent years. A road map for the relevant heart structures is an important asset for the success of the procedure and should be obtained before the intervention. This can be achieved by intra-cardiac echocardiography, conventional angiographic methods, multidetector CT, or MRI. The electrophysiological technique comprises a diagnostic procedure and an interventional – therapeutic – procedure. Electrocardiographic-gated multidetector CT is important in the diagnostic session to evaluate the anatomical details in combination with electric activity mapping. This combined protocol provides a unique view of the propagation of electrical activity, either normal or abnormal, over cardiac structures and allows a precise functional and anatomical evaluation to be obtained. In this review, we evaluate the role of electrocardiographic-gated multidetector CT in roadmapping arrhythmias in the paediatric age group, focussing on its strengths; we also evaluated some additional aspects that need further improvement in the future.

Copyright

Corresponding author

Correspondence to: S. N. K. Khalil, Resident of Radiology, Radiology Department, Faculty of Medicine, Ain Shams University, Abbassia, 11517 Cairo, Egypt. Tel: +201009006270; E-mail: dr_sameh_khalil@yahoo.com

References

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1. Haramati, LB, Glickstein, JS, Issenberg, HJ, Haramati, N, Crooke, GA. MR imaging and CT of vascular anomalies and connections in patients with congenital heart disease: significance in surgical planning. Radiographics 2002; 22: 337347.
2. Efstathopoulos, EP, Katritsis, DG, Kottou, S, et al. Patient and staff radiation dosimetry during cardiac electrophysiology studies and catheter ablation procedures: a comprehensive analysis. Eur Soc Cardiol 2006; 8: 443448.
3. Watson, T, Mah, E, Joseph, U, et al. Effective radiation dose in computed tomographic angiography of the chest and diagnostic cardiac catheterization in pediatric patients. Pediatr Cardiol 2013; 34: 518524.
4. Leschka, S, Oechslin, E, Husmann, L, et al. Pre- and postoperative evaluation of congenital heart disease in children and adults with 64-section CT. Radiographics 2007; 27: 829846.
5. Takatsuki, S, Mitamura, H, Ieda, M, Ogawa, S. Accessory pathway associated with an anomalous coronary vein in a patient with Wolff–Parkinson–White syndrome. J Cardiovasc Electrophysiol 2001; 12: 10801082.
6. Sun, Y, Arruda, M, Otomo, K, et al. CS-ventricular accessory connections producing posteroseptal and left posterior accessory pathways: incidence and electrophysiological identification. Circulation 2002; 106: 13621367.
7. Volkmer, M, Antz, M, Hebe, J, Kuck, KH. Focal atrial tachycardia originating from the musculature of the CS. J Cardiovasc Electrophysiol 2002; 13: 6871.
8. Saremi, F, Krishnan, S. Cardiac conduction system: anatomic landmarks relevant to interventional electrophysiologic techniques demonstrated with 64-detector CT. Radiographics 2007; 27: 15391567.
9. Khan, F, Virdee, MS, Gopalan, D, et al. Characterization of the suitability of coronary venous anatomy for targeting left ventricular lead placement in patients undergoing cardiac resynchronization therapy. Europace 2009; 11: 14911495.
10. Tsao, HM, Wu, MH, Yu, WC. Role of right middle pulmonary vein in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol 2001; 12: 13531357.
11. Yazar, F, Ozdogmus, O, Tuccar, E, Bayramoglu, A, Ozan, H. Drainage patterns of middle lobe vein of right lung: an anatomical study. Eur J Cardiothorac Surg 2002; 22: 717720.
12. Sugimoto, S, Izumiyama, O, Yamashita, A, Baba, M, Hasegawa, T. Anatomy of inferior pulmonary vein should be clarified in lower lobectomy. Ann Thorac Surg 1998; 66: 17991800.
13. Ghaye, B, Szapiro, D, Dacher, J, et al. Percutaneous ablation for atrial fibrillation:the role of cross sectional imaging. Radiographics 2003; 23: S19S33.
14. Tsao, HM, Wu, MH, Chern, MS, et al. Anatomic relationship of the esophagus and CS. J Cardiovasc Electrophysiol 2006; 17: 266269.
15. Kajihara, K, Nakano, Y, Hirai, Y, et al. Variable procedural strategies adapted to anatomical characteristics in catheter ablation of the cavotricuspid isthmus using a preoperative multidetector computed tomography analysis. J Cardiovasc Electrophysiol 2013; 24: 13441351.
16. Berdajs, D, Patonay, L, Turina, MI. The clinical anatomy of the sinus node artery. Ann Thorac Surg 2003; 76: 732735.
17. Sow, ML, Ndoye, JM, Lo, EA. The artery of the sinuatrial node: anatomic considerations based on 45 injection-dissections of the heart. Surg Radiol Anat 1996; 18: 103109.
18. Cabrera, JA, Ho, SY, Climent, V. The architecture of the left lateral atrial wall: a particular anatomic region with implications for ablation of atrial fibrillation. Eur Heart J 2008; 29: 356362.
19. Cabrera, JA, Sánchez-Quintana, D. Cardiac anatomy what the electrophysiologist needs to know. Heart 2013; 00: 115.
20. Saremi, F, Pourzand, L, Krishnan, S, et al. Right atrial cavotricuspid isthmus: anatomic characterization with multi-detector row CT1. Radiology 2008; 247: 658668.
21. Anderson, RH, Ho, HY, Becker, AE. Anatomy of the human atrioventricular junctions revisited. Anat Rec 2000; 260: 8191.
22. Chiang, SJ, Tsao, HM, Wu, MH. Anatomic characteristics of the left atrial isthmus in patients with atrial fibrillation: lessons from computed tomographic images. J Cardiovasc Electrophysiol 2006; 17: 12741278.
23. Ho, SY, Sanchez Quintana, D, Cabrera, JA, Anderson, RH. Anatomy of the left atrium: implications for radiofrequency ablation of atrial fibrillation. J Cardiovasc Electrophysiol 1999; 10: 15251533.
24. Walsh, EP, Cecchin, F. Arrhythmias in adult patients with congenital heart disease. Circulation 2007; 115: 534545.
25. Shiozaki, A, Senra, T, Edmundo Arteaga, E, Filho, M, Pita, CG, Ávila, F. Myocardial fibrosis detected by cardiac CT predicts ventricular fibrillation/ventricular tachycardia events in patients with hypertrophic cardiomyopathy. J Cardiovasc Comput Tomogr 2013; 7: 173181.
26. Dickinson, DF, Wilkinson, JL, Anderson, KR, Smith, A, Ho, SY, Anderson, RH. The cardiac conduction system in situs ambiguous. Circulation 1979; 59: 879885.
27. Momma, K, Takao, A, Shibata, T. Characteristics and natural history of abnormal atrial rhythms in left isomerism. Am J Cardiol 1990; 65: 231236.
28. Cochet, H, Dubois, R, Sacher, F, et al. Cardiac arrythmias: multimodal assessment integrating body surface ECG mapping into cardiac imaging. Radiology 2014; 271: 239247.

Keywords

Role of low kilovoltage electrocardiographic-gated multidetector CT in electrophysiological procedures in the paediatric age group

  • Sameh N. K. Khalil (a1) and Ahmed S. Ibrahim (a1)

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