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(Circulation. 2000;102:e103.)
© 2000 American Heart Association, Inc.

Images in Cardiovascular Medicine

Visualization of Automatic Implantable Cardioverter-Defibrillator Patches Using Electron Beam Angiography

Matthew J. Budoff, MD; Hamid Bakhsheshi, RT; Bin Lu, MD

From the Department of Medicine, Division of Cardiology, Harbor-UCLA Medical Center, Torrance, Calif.

Our patient was an 85-year-old man who had experienced an out-of-hospital cardiac arrest in September 1990 and subsequently underwent the implantation of an automatic implantable cardioverter-defibrillator as part of the Cardiac Arrest in Seattle: Conventional versus Amiodarone Drug Evaluation (CASCADE) trial, as well as bypass surgery in Seattle, Wash. The defibrillator was placed abdominally. The patient did quite well for 10 years. Then, he developed atypical chest pain and was referred for coronary angiography to evaluate the status of the bypass grafts. The patient was concerned because of previous complications from angiography, and so he underwent electron beam angiography with 3D reconstruction to assess his bypass graft patency. Electron beam angiography was performed using the Ultrafast Computed Tomography 150XLP (Imatron Inc). All 3 saphenous vein grafts were patent, and a second reconstruction was performed to visualize the patches and leads of the automatic implantable cardioverter-defibrillator (Figure).

View larger version (49K): [in this window] [in a new window]   Figure 1. The 3D images confirmed the patency of all 3 saphenous vein grafts (1 indicates obtuse marginal; 2, left anterior descending; and 3, distal right coronary), and we could also visualize the patches and leads of the automatic implantable cardioverter-defibrillator. There are 2 epicardial patches (P), one placed anteriorly over the right ventricle and one placed posteriorly over the left ventricle. Two epicardial rate-sensing leads (L) are also visualized.

Footnotes

Reprint requests to Matthew J. Budoff, MD, Saint John’s Cardiovascular Research Center, 1124 West Carson Street, RB-2, Torrance, CA 90502.

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Budoff, M. J. Articles by Lu, B. Search for Related Content PubMed PubMed Citation Articles by Budoff, M. J. Articles by Lu, B. Pubmed/NCBI databases Medline Plus Health Information Pacemakers and Implantable Defibrillators Related Collections Ablation/ICD/surgery CV surgery: coronary artery disease Computerized tomography and Magnetic Resonance Imaging