Salvage of diagnostic quality of image acquired by low-radiation-dose prospectively ECG-triggered coronary CTA during ventricular trigeminy: A case report of a novel image processing method

Cardiac arrhythmias, whether ventricular or supraventricular, initially presented a challenge for coronary computed tomography angiography (CCTA) because they could result in motion artifact during image acquisition, increased acquisition times, and increased radiation dose.1 Cardiac motion and misregistration artifacts in a scan performed during premature ventricular contractions can significantly compromise image quality and prevent diagnostic evaluation of the coronary arteries.2,3 Even the so-called “regularly irregular” rhythms, which are predictable, can trigger arrhythmia rejection algorithms4,5 during electrocardiogram (ECG)-gated imaging, delaying image acquisition to the next cardiac cycle and hence increasing the total radiation dose.