BACKGROUND: The majority of patients receiving implantable cardioverter-defibrillator (ICD) implantation under current guidelines never develop sustained ventricular arrhythmia; therefore, better markers of risk for sustained ventricular tachycardia and/or ventricular fibrillation are needed. OBJECTIVE: The purpose of this study was to identify cardiac magnetic resonance arrhythmic risk predictors of ischemic cardiomyopathy before ICD implantation. METHODS: Forty-three subjects (mean age, 64.5 ± 11.9 years) with previous myocardial infarction who were referred for ICD implantation were evaluated by cardiac magnetic resonance imaging (MRI). The MRI protocol included left ventricular functional parameter assessment using steady-state free precession and late gadolinium enhancement MRI using inversion recovery fast gradient echo. Left ventricular functional parameters were measured using cardiac magnetic resonance software. Subjects were followed up for 6-46 months, and the events of appropriate ICD treatments (shocks and antitachycardia pacing) were recorded. RESULTS: Twenty-eight patients experienced 46 spontaneous episodes during a median follow-up duration of 30 months. The total myocardial infarct (MI) size (18.05 ± 11.44 g vs 38.83 ± 19.87 g; P = .0006), MI core (11.63 ± 7.14 g vs 24.12 ± 12.73 g; P = .0002), and infarct gray zone (6.43 ± 4.64 g vs 14.71 ± 7.65 g; P = .0004) were significantly larger in subjects who received appropriate ICD therapy than in those who did not experience an episode of ventricular tachycardia and/or ventricular fibrillation. Multivariate regression analyses for the infarct gray zone and MI core adjusted for New York Heart Association class, diabetes, and etiology (primary or secondary prevention) revealed that the gray zone and MI core were predictors of appropriate ICD therapies (P = .0018 and P = .007, respectively). CONCLUSION: The extent of MI scar may predict which patients would benefit most from ICD implantation.
BACKGROUND: The majority of patients receiving implantable cardioverter-defibrillator (ICD) implantation under current guidelines never develop sustained ventricular arrhythmia; therefore, better markers of risk for sustained ventricular tachycardia and/or ventricular fibrillation are needed. OBJECTIVE: The purpose of this study was to identify cardiac magnetic resonance arrhythmic risk predictors of ischemic cardiomyopathy before ICD implantation. METHODS: Forty-three subjects (mean age, 64.5 ± 11.9 years) with previous myocardial infarction who were referred for ICD implantation were evaluated by cardiac magnetic resonance imaging (MRI). The MRI protocol included left ventricular functional parameter assessment using steady-state free precession and late gadolinium enhancement MRI using inversion recovery fast gradient echo. Left ventricular functional parameters were measured using cardiac magnetic resonance software. Subjects were followed up for 6-46 months, and the events of appropriate ICD treatments (shocks and antitachycardia pacing) were recorded. RESULTS: Twenty-eight patients experienced 46 spontaneous episodes during a median follow-up duration of 30 months. The total myocardial infarct (MI) size (18.05 ± 11.44 g vs 38.83 ± 19.87 g; P = .0006), MI core (11.63 ± 7.14 g vs 24.12 ± 12.73 g; P = .0002), and infarct gray zone (6.43 ± 4.64 g vs 14.71 ± 7.65 g; P = .0004) were significantly larger in subjects who received appropriate ICD therapy than in those who did not experience an episode of ventricular tachycardia and/or ventricular fibrillation. Multivariate regression analyses for the infarct gray zone and MI core adjusted for New York Heart Association class, diabetes, and etiology (primary or secondary prevention) revealed that the gray zone and MI core were predictors of appropriate ICD therapies (P = .0018 and P = .007, respectively). CONCLUSION: The extent of MI scar may predict which patients would benefit most from ICD implantation.
Authors: Paul A Scott; John M Morgan; Nicola Carroll; David C Murday; Paul R Roberts; Charles R Peebles; Stephen P Harden; Nick P Curzen Journal: Circ Arrhythm Electrophysiol Date: 2011-04-14
Authors: Andrew E Epstein; John P DiMarco; Kenneth A Ellenbogen; N A Mark Estes; Roger A Freedman; Leonard S Gettes; A Marc Gillinov; Gabriel Gregoratos; Stephen C Hammill; David L Hayes; Mark A Hlatky; L Kristin Newby; Richard L Page; Mark H Schoenfeld; Michael J Silka; Lynne Warner Stevenson; Michael O Sweeney; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Jeffrey L Anderson; Christopher E Buller; Mark A Creager; Steven M Ettinger; David P Faxon; Jonathan L Halperin; Loren F Hiratzka; Sharon A Hunt; Harlan M Krumholz; Frederick G Kushner; Bruce W Lytle; Rick A Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel; Lynn G Tarkington; Clyde W Yancy Journal: Circulation Date: 2008-05-15 Impact factor: 29.690
Authors: Stijntje D Roes; C Jan Willem Borleffs; Rob J van der Geest; Jos J M Westenberg; Nina Ajmone Marsan; Theodorus A M Kaandorp; Johan H C Reiber; Katja Zeppenfeld; Hildo J Lamb; Albert de Roos; Martin J Schalij; Jeroen J Bax Journal: Circ Cardiovasc Imaging Date: 2009-03-23 Impact factor: 7.792
Authors: Andrew T Yan; Adolphe J Shayne; Kenneth A Brown; Sandeep N Gupta; Carmen W Chan; Tuan M Luu; Marcelo F Di Carli; H Glenn Reynolds; William G Stevenson; Raymond Y Kwong Journal: Circulation Date: 2006-06-26 Impact factor: 29.690
Authors: Stefan de Haan; Thomas A Meijers; Paul Knaapen; Aernout M Beek; Albert C van Rossum; Cornelis P Allaart Journal: Heart Date: 2011-09-13 Impact factor: 5.994
Authors: Peter Bernhardt; Sascha Stiller; Eva Kottmair; Ludwig Binner; Jochen Spiess; Georg Grossmann; Volker Rasche; Daniel Walcher; Vinzenz Hombach Journal: Int J Cardiovasc Imaging Date: 2010-10-19 Impact factor: 2.357
Authors: Hiroshi Ashikaga; Tetsuo Sasano; Jun Dong; M Muz Zviman; Robert Evers; Bruce Hopenfeld; Valeria Castro; Robert H Helm; Timm Dickfeld; Saman Nazarian; J Kevin Donahue; Ronald D Berger; Hugh Calkins; M Roselle Abraham; Eduardo Marbán; Albert C Lardo; Elliot R McVeigh; Henry R Halperin Journal: Circ Res Date: 2007-10-04 Impact factor: 17.367
Authors: Marcello Disertori; Michele M Gulizia; Giancarlo Casolo; Pietro Delise; Andrea Di Lenarda; Giuseppe Di Tano; Maurizio Lunati; Luisa Mestroni; Jorge Salerno-Uriarte; Luigi Tavazzi Journal: J Cardiovasc Med (Hagerstown) Date: 2016-04 Impact factor: 2.160