Despite all promising advances, some challenges remain for ECG-gated multislice CT examinations of the heart and the coronary arteries with current 4-slice detectors: adequate visualization of stents and severely calcified coronary arteries, examination of patients with higher heart rates and patients, who cannot adequately hold their breath for at least 30 sec. The new generation of multislice CT systems offering simultaneous acquisition of up to 16 sub-millimeter slices and gantry rotation times shorter than 0.5 sec has the potential to overcome these limitations. We describe the technical principles of cardiac scanning with a state-of-the-art 16-slice CT equipment (SOMATOM Sensation 16, Siemens AG, Forchheim, Germany). We discuss an extension of the Adaptive Cardio Volume (ACV) reconstruction approach for ECG-gated multislice spiral CT. We show the impact of reduced gantry rotation time (0.42 sec) on temporal resolution, and we demonstrate the influence of slice width on the visualization of stents and plaques. Deviating from general purpose applications a cone-correction is not required for cardiac scanning with 16-slice CT systems. In addition to the absolute improvement, the temporal resolution shows a different dependence on the patient's heart rate for 0.42 sec rotation time, reaching its optimum (105 msec) at 81 BPM. This has the potential to expand the range of heart rates accessible to routine clinical examinations. Owing to sub-millimeter slice width and optimized in-plane resolution characteristics, visualization of stents and severe calcifications in coronary arteries is significantly improved. Clinical experience will be needed to fully evaluate the potential of 16-slice technology for cardiac imaging.