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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Cardiac CT: Imaging of and Through Cardiac Devices

Gary S Mak1, Quynh A Truong

  • 1Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA 02114, USA.

Current Cardiovascular Imaging Reports
|April 30, 2013
PubMed

Insights

Cardiac computed tomography (CT) is crucial for imaging patients with cardiac devices like pacemakers and defibrillators. This review highlights CT

Area of Science:

  • Cardiovascular Imaging
  • Medical Devices
  • Radiology

Background:

  • Cardiac computed tomography (CT) is the preferred imaging modality for patients with cardiac devices due to its high resolution and lack of contraindications associated with metal implants.
  • Echocardiography and nuclear studies have limitations compared to CT in this population.
  • Cardiac magnetic resonance imaging (CMR) is contraindicated in patients with certain metallic cardiac devices.

Purpose of the Study:

  • To review the evaluation and potential pitfalls of coronary arterial imaging in patients with cardiac devices.
  • To discuss complications associated with CT imaging in patients with devices, including lead perforation and CT interference.
  • To explore the role of CT in pre- and post-procedural assessment for cardiac resynchronization therapy (CRT) and myocardial scar evaluation for ventricular tachycardia ablation.

Main Methods:

  • Review of existing literature on cardiac CT imaging in patients with pacemakers, implantable defibrillators, and CRT devices.
  • Discussion of CT protocols and interpretation for coronary artery imaging, lead assessment, and myocardial scar evaluation.
  • Analysis of CT utility in assessing left ventricular assist device (LVAD) function and complications.

Main Results:

  • CT offers superior resolution for coronary imaging compared to echocardiography and nuclear studies in patients with cardiac devices.
  • Potential complications include lead perforation and safety concerns related to CT interference.
  • CT is valuable for pre- and post-procedural CRT assessment, including coronary venous imaging and myocardial scar assessment for VT ablation.
  • CT aids in evaluating LVAD function and complications.

Conclusions:

  • Cardiac CT is indispensable for comprehensive imaging of patients with cardiac devices, offering detailed anatomical and functional assessment.
  • Careful consideration of potential pitfalls and safety concerns is necessary when performing CT in this population.
  • Future research may integrate CT findings with electrophysiological data for advanced CRT patient management.

Keywords:
Cardiac CTCardiac resynchronization therapyDefibrillatorLeft Ventricular assist devicePacemaker

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