Cardiac magnetic resonance imaging provided an additional diagnostic yield in 54.2% of patients with frequent idiopathic ventricular arrhythmias, most commonly identifying previous myocarditis.
Observational (n=72)
No
Does cardiac magnetic resonance (CMR) imaging provide additional diagnostic yield in patients with frequent idiopathic ventricular arrhythmias and normal echocardiography?
CMR provides significant additional diagnostic yield in over half of patients with frequent idiopathic ventricular arrhythmias and normal echocardiograms, primarily identifying previous myocarditis.
Background: A routine diagnostic work-up does not identify structural abnormalities in a substantial proportion of patients with idiopathic ventricular arrhythmias (VAs). We investigated the added value of cardiac magnetic resonance (CMR) imaging in this group of patients. Methods: A single-centre prospective study was undertaken of 72 patients (mean age 46 ± 16 years; 53% females) with frequent premature ventricular contractions (PVCs ≥ 500/24 h) and/or non-sustained ventricular tachycardia (NSVT), an otherwise normal electrocardiogram, normal echocardiography and no coronary artery disease. Results: CMR provided an additional diagnostic yield in 54.2% of patients. The most prevalent diagnosis was previous myocarditis (23.6%) followed by possible PVC-related cardiomyopathy (20.8%), non-ischaemic cardiomyopathy (8.3%) and ischaemic heart disease (1.4%). The predictors of abnormal CMR findings were male gender, age and PVCs/NSVT non-outflow tract-related or with multiple morphologies. Patients with VAs had an impaired peak left ventricular (LV) global radial strain (GRS) compared with the controls (28.88% (IQR: 25.87% to 33.97%) vs. 36.65% (IQR: 33.19% to 40.2%), p < 0.001) and a global circumferential strain (GCS) (−17.66% (IQR: −19.62% to −16.23%) vs. −20.66% (IQR: −21.72% to −19.6%), p < 0.001). Conclusion: CMR reveals abnormalities in a significant proportion of patients with frequent idiopathic VAs. Male gender, age and non-outflow tract PVC origin can be clinical indicators for CMR referral.
Nikolaidou et al. (Fri,) conducted a observational in Frequent idiopathic ventricular arrhythmias (n=72). Cardiac magnetic resonance (CMR) imaging was evaluated on Additional diagnostic yield. Cardiac magnetic resonance imaging provided an additional diagnostic yield in 54.2% of patients with frequent idiopathic ventricular arrhythmias, most commonly identifying previous myocarditis.