Impact of ICD Artifact Burden on Late Gadolinium Enhancement Cardiac MR Imaging in Patients Undergoing Ventricular Tachycardia Ablation.
Background Cardiac magnetic resonance imaging (CMRI) is the gold standard for myocardial scar evaluation. Although ideal for substrate assessment in ventricular tachycardia (VT), most patients have an implantable cardioverter-defibrillator (ICD) at presentation for ablation. This study evaluates the...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 37; no. 10; pp. 1274 - 1284 |
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| Autores principales: | , , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103897751&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103897751 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Oct2014 vid: 37 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 103897751 98623914 10.1111/pace.12405 NLM24766563 103897751 ppf: 1274 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Impact of ICD Artifact Burden on Late Gadolinium Enhancement Cardiac MR Imaging in Patients Undergoing Ventricular Tachycardia Ablation. aug: au: Mesubi, Olurotimi Ahmad, Ghada Jeudy, Jean Jimenez, Alejandro Kuk, Richard Saliaris, Anastasios See, Vincent Shorofsky, Stephen Dickfeld, Timm affil: Maryland Arrhythmia and Cardiology Imaging Group (MACIG), University of Maryland; Division of Cardiology, University of Maryland; Division of Cardiovascular Medicine, University of Iowa sug: subj: Defibrillators, Implantable Contrast Media Therapeutic Use Tachycardia, Ventricular Therapy Catheter Ablation Magnetic Resonance Imaging Artifacts Therapy, Computer Assisted Human Descriptive Statistics Pretest-Posttest Design Maryland Academic Medical Centers Data Analysis Software Chi Square Test Middle Age Aged Male Female Correlation Coefficient Retrospective Design Funding Source Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background Cardiac magnetic resonance imaging (CMRI) is the gold standard for myocardial scar evaluation. Although ideal for substrate assessment in ventricular tachycardia (VT), most patients have an implantable cardioverter-defibrillator (ICD) at presentation for ablation. This study evaluates the ICD artifact burden during standard late gadolinium enhancement CMRI (LGE-CMRI) evaluation of myocardial scar in VT patients with ICDs. Methods Thirty-one patients with ICD and cardiomyopathy underwent LGE-CMRI using 1.5-T magnetic resonance scanner before VT ablation. Using the American Heart Association (AHA) 17-segment model, short-axis LGE series were analyzed for artifact burden localization and assessment. Results Preablation CMRI was performed in 31 patients with single chamber (n = 13), dual chamber (n = 11), and biventricular (n = 7) ICDs. Pre- and post-MRI ICD parameters were unchanged. All patients had susceptibility artifact and 51.6% (256 of 496) of segments were affected by artifact. The artifact area (178 ± 136 cm2) resulted in an artifact burden of 54 ± 21% of the LV myocardial area (327 ± 15 cm2). The anterior wall was most affected by artifact (89%) compared with 52%, 49%, and 23% in the lateral, septal, and inferior walls, respectively (P < 0.0001). The apical segments had more artifact burden (66%) than the mid (49%) and basal (44%) segments (P = 0.0005). Artifact area correlated with ICD-heart distance on anteroposterior chest radiograph (r = 0.42, P = 0.021) and body mass index (r = -0.48, P = 0.008). Conclusions Current clinical LGE-CMRI scar imaging protocols produce ICD artifacts that affect >50% of the LV myocardium and correlate with the ICD-heart distance. This significantly limits the application of CMRI for image-guided VT ablation. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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