SPC365

The role of Cardiac Magnetic Resonance to study unexplained or suspected arrhythmias

Session: Posters - B. Imaging
Speaker: Francisco Manuel Dias Cláudio

Congress: CPC 2021
Topic: B. Imaging
Theme: 03. Imaging
Subtheme: 03.3 Cardiac Magnetic Resonance
Session Type: Posters
FP Number: ---
Authors: Francisco Dias Cláudio; Bruno Piçarra; David Neves; Manuel Trinca
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> </span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Etiology of cardiac arrhythmias is often difficult to determine. Cardiac Magnetic Resonance is the gold standard to anatomical and functional cardiac evaluation, and may represent a fundamental technique for accurate assessment of myocardial arrhythmic substrates.</span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Purpose:</strong> </span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">The aim of this study is to impact of CMR in determining arrhythmic risk stratification and&nbsp; diagnostic in patients with suspected or confirmed arrhythmias.</span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> </span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">We performed a seven-year prospective study of patients with suspected or confirmed arrhythmias in which other techniques did not provide a definitive diagnosis. These patients underwent CMR for diagnostic and risk stratification assessment. We applied a protocol to evaluate both ventricles&rsquo; morphology and functional and late gadolinium enhancement (LGE) presence. </span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results</strong><strong>:</strong> </span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">97 patients were included in the analyses. 63% of the subjects were male with a mean age of 46 &plusmn; 17 years old. The indications for patients with suspected or confirmed arrhythmias performing CMR evaluation were the following: 30,9% (n=30) of the patients had very frequent premature ventricular complexes, 25,8% (n=25) had sustained ventricular tachycardia (VT), 10,3% (n=10) unexplained recurrent syncope, 11,4% (n=11) suspected structural heart disease with arrhythmogenic substract, 6,2 % (n=6) supraventricular tachycardia, 5,2% (n=5) palpitations, 4,1% (n=4), non-sustained VT, and 3,1% (n=3) aborted sudden cardiac death, and 3% other indications. Depressed ejection fraction (EF)(&lt;50%) was present in 15,5% (n=15) for LV (mean EF 43&plusmn;9%). Dilation of LV was found in 28,9% of patients (n=28, mean LV volume: 116&plusmn;16ml/m&sup2;), with RV dilation being present in 2 patients, (RV volume: 144&plusmn;11ml/m&sup2;). 16,5% had interventricular septum hypertrophy (mean 15&plusmn;4mm/m<sup>2</sup>). Left atrium dilation was observed in 118,6% (n=18) of patients (mean area of 17&plusmn;2cm<sup>2</sup>/m<sup>2</sup>), and right atrium was dilated in only one. CMR contributed to establish either a diagnosis or identifying an arrhythmogenic substrate in 21,7% of patients. Hypertrophic cardiomyopathy was diagnosis in 5,2% (n=5). The same number of non-ischemic dilated cardiomyopathy were diagnosed. 2,1% (n=2) had a myocarditis sequelae and 2,1% (n=2) had right ventricular arrhythmogenic dysplasia. LV non-compaction and a non-ischemic dilated cardiomyopathy were diagnosed in 3,1% of the cases each. 1% had sequelae from a silent myocardial ischemia. In 13,4% (n=13) we found nonspecific variations, which deserve follow-up. On the remaining patients, CMR was considered normal.</span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong><strong> </strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">CMR allowed an increase on diagnosis in 21,7% of the patients with suspected or confirmed arrhythmias. This methods represents a highly reproducible exam and reliable, that can support the arrhythmic risk stratification&nbsp; and diagnosis of our population&nbsp; when such diagnosis remains elusive with other methods.</span></span></p>