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"The presence of mechanical heart valves, pacemaker leads and ay other foreign body around the heart can interfere with the quality of the image."
http://www.scandirectory.com/content/body_scan_technology.asp
Also, I know personally that they can't get an image on the atria if you are in afib. I showed up for the test in afib and they couldn't do the CTA until I had been cardioverted about a week later. So if you have a pacemaker because of an AV ablation and afib, they will only be able to look at the coronary arteries feeding the ventricals. But in general the presense of a pacemaker will help sinc the scan to the ventricle's motion. In my case, without a pacemaker, the afib caused the ventricles to beat randomly and so they couldn't sinc and form an image.