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

² Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Headington, OX3 9DU Oxford, UK

³ First Department of Cardiology, AHEPA Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece

^*Correspondence: tkaramitsos@auth.gr (Theodoros D. Karamitsos)

Rev. Cardiovasc. Med. 2023, 24(9), 252; https://doi.org/10.31083/j.rcm2409252

Submitted: 11 May 2023 | Revised: 5 June 2023 | Accepted: 12 June 2023 | Published: 15 September 2023

(This article belongs to the Special Issue State-of-the-Art Reviews on Cardiovascular Magnetic Resonance Imaging: the Present and the Future)

This is an open access article under the CC BY 4.0 license.

Abstract

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.

Keywords

Cardiovascular magnetic resonance

cardiac arrhythmias

high-quality CMR imaging

cardiomyopathy

Figures

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Fig. 1.

Late gadolinium enhancement pattern in myocardial infarction. Different extent of myocardial infarction on phase-sensitive inversion recovery (PSIR) late gadolinium enhancement images. (A) mid-ventricular short axis slice showing a subendocardial infarction, $\sim$ 50% wall thickness in the mid-inferior wall (arrow); (B) horizontal long axis view showing a subendocardial infarction, $\sim$ 75% wall thickness in the basal anterolateral wall (arrow); (C) left ventricular outflow tract view showing two large transmural myocardial infarctions, one involving the anteroseptum and apex and one affecting the inferolateral wall (arrows), with an apical thrombus (arrowhead).

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Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174