Cardiac 123I-mIBG imaging provides incremental prognostic value beyond LVEF in heart failure patients and shows potential for predicting sustained ventricular tachyarrhythmias and guiding ablation.
Does 123I-mIBG imaging help identify sustained ventricular tachycardia and guide ablation in patients with cardiomyopathy?
123I-mIBG imaging of the cardiac nervous system may offer a novel approach to refine ICD qualification criteria and guide ventricular tachycardia ablation in patients with cardiomyopathy.
Implantable cardioverter-defibrillators (ICDs) significantly reduce mortality in patients with depressed left ventricular ejection fraction (LVEF) and heart failure (HF). However, shortcomings of LVEF to accurately identify those at greatest risk of ventricular tachyarrhythmias have led to the pursuit of alternative means to refine qualification criteria for ICD implantation. It is well established that imaging the cardiac nervous system with(123)I meta-iodobenzylguanidine ((123)I-mIBG) provides incremental prognostic value in patients with HF beyond LVEF. Whether (123)I-mIBG will also play an important role for identifying and/or predicting sustained ventricular tachyarrhythmias in patients with cardiomyopathy and determining those who may benefit from ICD implantation is currently under investigation. Novel imaging approaches that pinpoint the site of ventricular arrhythmias and guide ventricular tachycardia ablation are presented.
Klein et al. (2013) conducted a review in Cardiomyopathy and Heart Failure. 123I-mIBG imaging was evaluated. Cardiac 123I-mIBG imaging provides incremental prognostic value beyond LVEF in heart failure patients and shows potential for predicting sustained ventricular tachyarrhythmias and guiding ablation.