Cardiac Magnetic Resonance in the Evaluation of Patients With Frequent Premature Ventricular Complexes

Hosseini, Farshad; Thibert, Michael J.; Gulsin, Gaurav S; Murphy, Darra; Alexander, G.; Andrade, Jason G.; Hawkins, Nathaniel M.; Laksman, Zachary; Yeung‐Lai‐Wah, John A.; Chakrabarti, Santabhanu; Bennett, Matthew T.; Krahn, Andrew D.; Deyell, Marc W.

doi:10.1016/j.jacep.2022.06.021

Cited by 5 publications

(1 citation statement)

References 23 publications

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“…Additionally, myocardial strain evaluated with CMR is more sensitive than LVEF in detecting incipient contractile dysfunction in patients with frequent idiopathic VAs and PVC-related or other types of underlying cardiomyopathy, and can thus guide early treatment [ 66 ]. Importantly, myocardial structural abnormalities detected on CMR can redefine patient prognosis and improve risk stratification, as they are associated with worse clinical outcomes, such as nonfatal episodes of ventricular fibrillation or sustained VT, resuscitated cardiac arrest, or SCD [ 89 , 90 ].…”

Section: Determining the Underlying Etiology Of Arrhythmiamentioning

confidence: 99%

The Role of Cardiovascular Magnetic Resonance Imaging in Patients with Cardiac Arrhythmias

Nikolaidou,

Ormerod,

Ziakas

et al. 2023

Rev. Cardiovasc. Med.

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Cardiac arrhythmias are associated with significant morbidity, mortality and poor quality of life. Cardiovascular magnetic resonance (CMR) imaging, with its unsurpassed capability of non-invasive tissue characterisation, high accuracy, and reproducibility of measurements, plays an integral role in determining the underlying aetiology of cardiac arrhytmias. CMR can reliably diagnose previous myocardial infarction, non-ischemic cardiomyopathy, characterise congenital heart disease and valvular pathologies, and also detect the underlying substrate concealed on conventional investigations in a significant proportion of patients with arrhythmias. Determining the underlying substrate of arrhythmia is of paramount importance for treatment planning and prognosis. However, CMR imaging in patients with irregular heart rates can be problematic. Understanding the different ways to overcome the limitations of CMR in arrhythmia is essential for providing high-quality imaging, comprehensive information, and definitive answers in this diverse group of patients.

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Section: Determining the Underlying Etiology Of Arrhythmiamentioning

confidence: 99%

The Role of Cardiovascular Magnetic Resonance Imaging in Patients with Cardiac Arrhythmias

Nikolaidou,

Ormerod,

Ziakas

et al. 2023

Rev. Cardiovasc. Med.

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Association between ventricular arrhythmia (premature ventricular contractions burden and nonsustained ventricular tachycardia) and cardiovascular events in patients without structural heart disease

Ogiso,

Arita,

Suzuki

et al. 2024

Journal of Arrhythmia

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BackgroundPremature ventricular contractions (PVCs) and nonsustained ventricular tachycardia (NSVT) are common arrhythmias in cardiovascular clinical settings. However, the clinical significance of PVCs and NSVT in the absence of structural heart disease has not yet been fully elucidated. This study aimed to evaluate the association between PVCs, NSVT, and clinical outcomes.MethodsA study population of 26,117 patients was drawn from the Shinken Database established in June 2004. We enrolled 6332 patients without structural heart disease who underwent 24‐h Holter monitoring and were registered up to March 2019. We focused on ventricular arrhythmias and cardiovascular events in patients without structural heart diseases. The study population was divided by the number of baseline PVCs (PVCs: <1000 (n = 5507), 1000–9999 (n = 531), and 10 000 ≤(n = 294)). The study population was also divided according to the presence or absence of NSVT (n = 454 and n = 5878, respectively).ResultDuring the follow‐up period up to 3 years, there were 16 deaths, 24 heart failure‐related hospitalizations, 14 acute coronary syndromes, and 37 embolism events. The frequency of PVCs was not associated with mortality or heart failure. On the other hand, the presence of NSVT was significantly associated with heart failure hospitalization in a multivariate model (hazard ratio: 3.02; 95% CI: 1.03–8.83; p = .044).ConclusionIn patients without structural heart disease, NSVT was associated with a higher risk of heart failure hospitalization. Patients with NSVT but no structural heart diseases require careful follow‐up and management of heart failure risk factors.

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Predictors of Myocardial Fibrosis Detected by CMR in Patients With Idiopathic PVCs

Ailoaei,

Șorodoc,

Ureche

et al. 2024

Noninvasive Electrocardiol

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BackgroundPremature ventricular contractions (PVCs) are a frequent electrocardiographic finding in routine medical practice, and 16% of the patients with idiopathic PVCs may have underlying heart disease.ObjectiveWe analyzed the correlation between the morphology of the PVCs and the myocardial scarring identified by cardiac magnetic resonance (CMR), together with the impact of late gadolinium enhancement (LGE) on the need for ablation.MethodsNinety‐four patients (median age 56 years) with frequent PVCs (> 500 PVCs on 24 h) and a structurally normal heart were referred for comprehensive CMR. The patients were followed for 12 months. Patients were referred for ablation if they were symptomatic in the context of frequent PVCs.ResultsThe prevalence of LGE identified by CMR was higher among males (OR 5.506 (2.092–14.49) p < 0.05), with an age ≥ 50 years (OR 1.047 (1.015–1.08), p < 0.05) and a higher PVC burden (OR 1.922 (1.723–1.976), p < 0.05). Additionally, patients with PVCs with a LBBB inferior axis had four times higher risk of exhibiting LGE (OR 4.09 (1.584–10.565), p < 0.05). In multivariate analysis, age (OR 1.059 (1.019–1.099), p < 0.05) and a LBBB inferior axis (OR 4.605 (1.472–14.404), p < 0.05) were independently associated with the presence of LGE.ConclusionPatients with PVCs and apparently, structurally normal heart present myocardial scarring identified by CMR in 71.23% of cases. PVCs with LBBB inferior axis pattern, age ≥ 50 years and male sex are associated with the presence of LGE on CMR. In multivariate analysis, age and LBBB inferior axis were independently correlated with the presence of LGE.

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Cardiac Magnetic Resonance in the Evaluation of Patients With Frequent Premature Ventricular Complexes

Cited by 5 publications

References 23 publications

The Role of Cardiovascular Magnetic Resonance Imaging in Patients with Cardiac Arrhythmias

The Role of Cardiovascular Magnetic Resonance Imaging in Patients with Cardiac Arrhythmias

Association between ventricular arrhythmia (premature ventricular contractions burden and nonsustained ventricular tachycardia) and cardiovascular events in patients without structural heart disease

Predictors of Myocardial Fibrosis Detected by CMR in Patients With Idiopathic PVCs

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