Ventricular tachycardia cardiac MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

When structural heart disease is suspected in the context of ventricular tachycardia, it is necessary to have an accurate evaluation of the structure and function of the atria and ventricles. While echocardiography is the first modality of choice, MRI is used when the assessment provided by echocardiography is not satisfactory. In addition, MRI seems to have an important role in the evaluation of suspected arrhythmogenic right ventricular cardiomyopathy because MRI provides a good assessment of the right ventricular structure, function and fatty infiltration if present.

Cardiac MRI

  1. Quantification of LVEF, left ventricular mass, and volume
  2. Anomaly of coronary arteries origin
  3. Valvular heart disease
  4. Myocardial scar
  5. Infiltrative process by late gadolinium enhancement
  6. LV , RV function
  7. Degree of fibrosis in LV, RV in HCM and ARVC


2017 AHA/ACC/HRS Guidelines for Management of Patients With Ventricular Arrhythmias

Class IIa
"1 Cardiac MRI or cardiac computed tomography (CT), can be useful in patients with ventricular arrhythmias when structural heart disease is considered. (Level of Evidence C)"

References

  1. Coleman, G. Cameron; Shaw, Peter W.; Balfour, Pelbreton C.; Gonzalez, Jorge A.; Kramer, Christopher M.; Patel, Amit R.; Salerno, Michael (2017). "Prognostic Value of Myocardial Scarring on CMR in Patients With Cardiac Sarcoidosis". JACC: Cardiovascular Imaging. 10 (4): 411–420. doi:10.1016/j.jcmg.2016.05.009. ISSN 1936-878X.
  2. Kiès P, Bootsma M, Bax J, Schalij MJ, van der Wall EE (2006). "Arrhythmogenic right ventricular dysplasia/cardiomyopathy: screening, diagnosis, and treatment". Heart Rhythm. 3 (2): 225–34. doi:10.1016/j.hrthm.2005.10.018. PMID 16443541.

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