Case Report: Hemodynamic consequences of severe supraventricular arrhythmia assessed by real-time magnetic resonance imaging in combination with electrocardiography

Figures

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  Figure 1. Initial ECG. Irregular heart rhythm with some sinus beats (green dots) along with numerous premature beats with different QRS complex morphologies typically preceded by a low-amplitude P wave, indicating aberrant conduction: narrow QRS complexes with a QRS vector similar to a sinus rhythm (dark purple squares) (QRS vector: ∼50°), narrow QRS complexes with a QRS vector of −20° (orange squares), and wide QRS complexes with a QRS vector of ∼−40° (blue squares).

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  Figure 2. Left ventricular volumetry. (A) Images at end-diastole and the corresponding end-systole of a midventricular slice of the short-axis stack. (B) The corresponding left ventricular volume curve of the short-axis stack, with the end-diastolic phase and the corresponding end-systolic phase of all slices determining the LV stroke volume. The contractions adjacent to the sinus beat are not exactly aligned in all the slices of the short-axis stack, and therefore, the volume values cannot be evaluated and are grayed out. (C) The corresponding ECG of the midventricular slice shows the time of the R-wave and the corresponding long RR interval before it and the short RR interval after it, which allows for classification of the beat as a sinus beat. LV, left ventricular; ED, end-diastole; ES, end-systole.

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  Figure 3. Real-time flow. (A) Aortic flow and (B) pulmonary flow over a duration of 30 s show that the amplitude after a long RR interval (sinus beat) is high, whereas the amplitude after a short RR interval (premature contraction) is low. While the amplitude of different premature beats in the aorta is similarly reduced, the amplitude of a premature contraction following a previous premature contraction in the pulmonary trunk is even lower.