Related Experiment Video

Updated: May 2, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

23.8K

Technical note: Electrocardiogram electrode repositioning for 320-row coronary CT angiography in patients with

Takeshi Kondo1, Hideyuki Matsutani2, John Groarke3

  • 1Department of Cardiology, Takase Clinic, 885-2 Minami-orui, Takasaki 370-0036, Japan.

Journal of Cardiovascular Computed Tomography
|March 4, 2014
PubMed

Insights

Simple ECG electrode repositioning improves coronary CT angiography (CTA) by enabling selective R wave triggering from premature ventricular contractions (PVCs). This technique enhances image quality and reduces radiation dose in patients with regular PVCs.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Medical Technology

Background:

  • Arrhythmias like premature ventricular contractions (PVCs) can degrade coronary CT angiography (CTA) image quality and increase radiation exposure.
  • Regularly occurring PVCs, such as bigeminy or quadrigeminy, present unique challenges for ECG-gated CTA acquisition.
  • Standard ECG triggering methods may be suboptimal in patients with frequent, patterned arrhythmias.

Observation:

  • Premature ventricular contractions (PVCs) often exhibit predictable, recurrent patterns with compensatory pauses.
  • Electrocardiographic (ECG) electrode repositioning can selectively amplify R waves of PVCs relative to sinus beats.
  • Combining ECG electrode repositioning with an absolute-delay strategy allows for precise triggering on PVC R waves.

Findings:

  • Six patients with PVC bigeminy or quadrigeminy underwent successful 320-row coronary CTA using selective R wave triggering of PVCs.
  • All studies achieved excellent image quality via single-heartbeat acquisition.
  • The median effective radiation dose was significantly reduced to 2.9 mSv, compared to higher doses (6.8 and 10.3 mSv) with standard triggering in two cases.

Implications:

  • This simple ECG electrode repositioning technique, coupled with an absolute-delay strategy, offers a valuable method for optimizing coronary CTA in patients with regular PVCs.
  • It facilitates high-quality imaging while substantially lowering radiation exposure.
  • This approach should be considered for routine use in patients undergoing coronary CTA with regular and recurrent PVCs.

Keywords:
320-row multidetector computed tomographyComputed tomography coronary angiographyCoronary arteryECG electrodePremature ventricular contractionsRadiation exposure

More Related Videos

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction06:57

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

16.6K
Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

2.4K

Related Concept Videos

Electrocardiogram Fundamentals01:28

Electrocardiogram Fundamentals

Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
2.2K
Electrocardiogram01:29

Electrocardiogram

An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
9.8K
Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
671
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
1.2K
Cardiac Action Potential01:30

Cardiac Action Potential

Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
11.8K
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
1.2K