INTRODUCTION: Cardiac magnetic resonance (CMR) imaging is increasingly important in the diagnostic work-up of a wide range of heart diseases, including those with arrhythmogenic potential. OBJECTIVE: To assess the added value of CMR in etiological diagnosis of ventricular arrhythmias after an inconclusive conventional investigation. METHODS: Patients undergoing CMR between 2005 and 2011 for investigation of ventricular arrhythmias were included (n=113). All had documented arrhythmias. Those with a definite diagnosis from a previous investigation and those with evidence of coronary artery disease (acute coronary syndrome, typical angina symptoms, increase in biomarkers or positive stress test) were excluded. CMR results were considered relevant when they fulfilled diagnostic criteria. RESULTS: Of the 113 patients, 57.5% were male and mean age was 41.7 ± 16.2 years. Regarding the initial arrhythmia, 38.1% had ventricular fibrillation/sustained ventricular tachycardia (VF/VT) and 61.9% had less complex ventricular ectopy. CMR imaging showed criteria of a specific diagnosis in 42.5% of patients, was totally normal in 36.3%, and showed non-specific alterations in the remainder. In VF/VT patients, specific criteria were found in 60.4%, and in 31.4% of those with less complex ectopy. The most frequent diagnoses were arrhythmogenic right ventricular dysplasia, ventricular non-compaction and myopericarditis. It is worth noting that, although there was no evidence of previous coronary artery disease, 6.2% of patients had a late gadolinium enhancement distribution pattern compatible with myocardial infarction. CONCLUSION: CMR gives additional and important information in the diagnostic work-up of ventricular arrhythmias after an inconclusive initial investigation. The proportion of patients with diagnostic criteria was 42.5% (60.0% in those with VF/VT), and CMR was completely normal in 36.6%.
INTRODUCTION: Cardiac magnetic resonance (CMR) imaging is increasingly important in the diagnostic work-up of a wide range of heart diseases, including those with arrhythmogenic potential. OBJECTIVE: To assess the added value of CMR in etiological diagnosis of ventricular arrhythmias after an inconclusive conventional investigation. METHODS:Patients undergoing CMR between 2005 and 2011 for investigation of ventricular arrhythmias were included (n=113). All had documented arrhythmias. Those with a definite diagnosis from a previous investigation and those with evidence of coronary artery disease (acute coronary syndrome, typical angina symptoms, increase in biomarkers or positive stress test) were excluded. CMR results were considered relevant when they fulfilled diagnostic criteria. RESULTS: Of the 113 patients, 57.5% were male and mean age was 41.7 ± 16.2 years. Regarding the initial arrhythmia, 38.1% had ventricular fibrillation/sustained ventricular tachycardia (VF/VT) and 61.9% had less complex ventricular ectopy. CMR imaging showed criteria of a specific diagnosis in 42.5% of patients, was totally normal in 36.3%, and showed non-specific alterations in the remainder. In VF/VTpatients, specific criteria were found in 60.4%, and in 31.4% of those with less complex ectopy. The most frequent diagnoses were arrhythmogenic right ventricular dysplasia, ventricular non-compaction and myopericarditis. It is worth noting that, although there was no evidence of previous coronary artery disease, 6.2% of patients had a late gadolinium enhancement distribution pattern compatible with myocardial infarction. CONCLUSION: CMR gives additional and important information in the diagnostic work-up of ventricular arrhythmias after an inconclusive initial investigation. The proportion of patients with diagnostic criteria was 42.5% (60.0% in those with VF/VT), and CMR was completely normal in 36.6%.
Authors: Giulio Conte; Bernard Belhassen; Pier Lambiase; Giuseppe Ciconte; Carlo de Asmundis; Elena Arbelo; Beat Schaer; Antonio Frontera; Haran Burri; Leonardo Calo'; Kostantinos P Letsas; Francisco Leyva; Bradley Porter; Johan Saenen; Valerio Zacà; Paola Berne; Peter Ammann; Marco Zardini; Blerim Luani; Roberto Rordorf; Georgia Sarquella Brugada; Argelia Medeiros-Domingo; Johann-Christoph Geller; Tom de Potter; Mathis K Stokke; Manlio F Márquez; Yoav Michowitz; Shohreh Honarbakhsh; Manuel Conti; Christian Sticherling; Annamaria Martino; Abbasin Zegard; Tardu Özkartal; Maria Luce Caputo; François Regoli; Rüdiger C Braun-Dullaeus; Francesca Notarangelo; Tiziano Moccetti; Gavino Casu; Christopher A Rinaldi; Moises Levinstein; Kristina H Haugaa; Nicolas Derval; Catherine Klersy; Moreno Curti; Carlo Pappone; Hein Heidbuchel; Josép Brugada; Michel Haïssaguerre; Pedro Brugada; Angelo Auricchio Journal: Europace Date: 2019-11-01 Impact factor: 5.214