Role of magnetic resonance imaging in the detection of myocardial fibrosis in life-threatening ventricular arrhythmias

Abstract

Sudden cardiac death (SCD) is a major medical, economic and social problem. Survival after SCD remains low. Its leading mechanism is fatal ventricular tachyarrhythmias. The only highly effective aid remains an implantable cardioverter defibrillator (ICD). According to modern concepts, myocardial fibrosis (MF) is the leading cause of life-threatening ventricular arrhythmias. Magnetic resonance imaging (MRI) has become the standard for non-invasive MF imaging and one of the leading methods for its quantification, which is why this method is recommended for determining indications for ICD implantation. MRI can show the scar location, which should be taken into account when placing the lead, and determine its size, which predicts the effectiveness of ICD implantation. Identification of MF in patients with life-threatening ventricular arrhythmias is an important area of research aimed at identifying the risk of SCD. Delayed contrast-enhanced MRI can be considered as a marker to improve SCD risk stratification.

Keywords

• sudden cardiac death
• ventricular arrhythmias
• myocardial fibrosis
• magnetic resonance imaging
• t1 mapping
• analysis of extracellular volume fraction