Feasiblity study of multidetector-row computed tomography (MDCT) for detection of the optimum coronary venous system in cardiac resynchronization therapy

Multidetector-row computed tomography (MDCT) is a non-invasive method of assessing coronary artery disease. Accurate evaluation of the coronary venous system (CVS) anatomy is required for left ventricular lead placement in cardiac resynchronization therapy (CRT). We assessed the resolution of CVS imaging by MDCT and examined the possibility for CRT application as a pilot study. We performed a pilot MDCT study in 10 patients who were scheduled for permanent pacemaker implantation or electrophysiological study. We measured the following: 1 coronary sinus (CS) ostium diameter, 2 CS branch diameter, 3 CS branch length, 4 angle between the CS branch and the main tract, 5 distance from CS ostium to the CS branch, in lateral, posterolateral and anterolateral branches. MDCT obtained CVS information in detail without any complications. MDCT may be helpful in detecting the optimal CS branch for CRT.