Sudden cardiac death MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Edzel Lorraine Co, DMD, MD[3]

Overview

Cardiac magnetic resonance imaging (MRI) is an accurate modality for diagnosis of structural and functional causes of cardiac arrest by the evaluation of chamber volumes, left ventricular and right ventricular mass, size and function, and regional wall motion abnormality.

MRI

• Cardiac magnetic resonance imaging (MRI) is an accurate modality for diagnosis of structural and functional causes of cardiac arrest by the evaluation of chamber volumes, left ventricular and right ventricular mass, size and function, and regional wall motion abnormality.
• This imaging identifies presence of myocardial edema, infiltration, fibrosis, and perfusion defects.

2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death

Recommendations for evaluation of patients presenting with newly documented ventricular arryhthmia

Class IIa (Level of Evidence: C)

In patients with newly documented ventricular arrhythmia (VA) (frequent premature ventricular contractions (PVCs), non-sustained ventricular tachycardia (NSVT)and suspicion of structural heart disease (SHD) other than coronary artery disease (CAD) after initial evaluation, a cardiac magnetic resonance (CMR) should be considered.

Recommendations for evaluation of sudden cardiac arrest survivors

Class I (Level of Evidence: B)

Coronary imaging and CMR with late gadolinium enhancement (LGE) are recommended for evaluation of cardiac structure and function in all SCA survivors without a clear underlying cause.

Recommendations for the management of patients with premature ventricular complex-induced or premature ventricular complex-aggravated cardiomyopathy

Class IIa (Level of Evidence: C)

In patients with suspected premature ventricular complex (PVC)-induced cardiomyopathy, cardiac magnetic resonance (CMR) should be considered.

Recommendations for evaluation of patients presenting with dilated cardiomyopathy/ hypokinetic non-dilated cardiomyopathy

Class IIa (Level of Evidence: B)

CMR with LGE should be considered in dilated cardiomyopathy (DCM)/hypokinetic non-dilated cardiomyopathy (HNDCM) patients for assessing the etiology and the risk of ventricular arryhthmia (VA)/ sudden cardiac death (SCD).

Recommendations for diagnosis of ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy

Class I (Level of Evidence: B)

In patients with suspected arrhythmogenic right ventricular cardiomyopathy (ARVC), CMR is recommended.

Recommendations for diagnosis of ventricular arrhythmias in hypertrophic cardiomyopathy

Class I (Level of Evidence: B)

CMR with LGE is recommended in HCM patients for diagnostic workup.

2017AHA/ACC/HRS Guideline for management of sudden cardiac arrest and ventricular arrhythmia

Class IIa (Level of Evidence: C)

Cardiac magnetic resonance imaging (CMR) or cardiac computer tomography is recommended in patients with ventricular arrhythmia for evaluation of structural heart disease