Open AccessImaging of patients with implanted devices and arrhythmia
Author(s) -
Nam Ju Lee,
Harold Litt
Publication year - 2016
Publication title -
sa journal of radiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.18
H-Index - 3
eISSN - 2078-6778
pISSN - 1027-202X
DOI - 10.4102/sajr.v20i2.1046
Subject(s) - medicine , ventricular tachycardia , cardiology , ablation , cardiac electrophysiology , implantable cardioverter defibrillator , magnetic resonance imaging , cardiac magnetic resonance imaging , tachycardia , catheter ablation , sudden cardiac death , radiology , electrophysiology
Expanding implantable cardioverter-defibrillator (ICD) indications and significant morbidity and mortality reduction benefits have resulted in a large number of routine ICD implants with appropriate ICD shocks for ventricular arrhythmias. The side-effects and lack of long-term efficacy of antiarrhythmics have made ventricular tachycardia (VT) ablation an increasingly attractive treatment option. Although cardiac magnetic resonance imaging (CMR) is considered the gold standard technique for imaging of myocardial fibrosis to diagnose and guide VT ablation targets in patients with cardiac arrhythmia, safety concerns and significant artifacts from the devices significantly limit the application of CMR. We discuss how to decrease artifact from cardiac devices and the role of a modified inversion pulse late gadolinium enhancement (LGE) CMR sequence as a useful tool in this setting, and we review techniques, safety protocols and limitations from the perspective of our institution’s experience