Ventricular tachycardia cardiac MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Aditya Ganti M.B.B.S. [3]

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 is an accurate modality for evaluation of the precursor of ventricular arrhythmia, or SCD including ischemic heart disease, myocarditis, cardiomyopathic process based on the following:^[1]

Cardiac magnetic resonance imaging can be especially helpful in the evaluation of uncommon myocardial infiltrative diseases, such as sarcoidosis.^[2]
MRI can be useful in patients with ventricular tachycardia when echocardiography fails to provide accurate evaluation of left or right ventricular function.

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)”

↑ 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.
↑ 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.