Abstract

MALDONADO, Sebastián et al. Diagnostic Value of Cardiac Magnetic Resonance in Patients with Frequent Ventricular Arrhythmia and Normal Doppler Echocardiography. Rev. argent. cardiol. [online]. 2013, vol.81, n.6, pp.498-504. ISSN 1850-3748.

Introduction Frequent ventricular arrhythmia can be a primary electrical disturbance or may be associated to cardiomyopathy. The prognostic and therapeutic impact depends on the presence of structural heart disease. Transthoracic Doppler echocardiography has been the most important complementary study to evaluate the presence of cardiac structural abnormalities. Objectives The aims of this study were to determine the ability of cardiac magnetic resonance imaging to detect structural heart disease in patients with normal Doppler echocardiography and to assess the incidence of adverse cardiovascular events during follow-up. Methods The study included 66 consecutive patients with frequent ventricular arrhythmia defined as > 5000 ventricular extrasystoles in a 24-hour Holter monitoring, ventricular tachycardia or resuscitated cardiac respiratory arrest with normal Doppler echocardiogram. All patients underwent cardiac magnetic resonance imaging to assess cardiomyopathies. Results Fifty-seven percent of patients had structural heart disease. The most prevalent diagnosed pathologies were myocarditis sequelae, non-compacted myocardium and subendocardial infarction scar. At mean follow-up of 24 ± 22 months, the incidence of adverse cardiovascular events was 6.06%. The number of ventricular extrasystoles was higher in patients with abnormal cardiac magnetic resonance. Conclusions This work demonstrates that in patients with frequent ventricular arrhythmia and normal Doppler echocardiogram, gadolinium cardiac magnetic resonance imaging can detect structural heart disease in more than half of the cases. Patients with frequent ventricular arrhythmia during Holter monitoring, normal Doppler and mild alterations in the magnetic resonance present low risk of cardiovascular events.

Keywords : Magnetic Resonance Imaging; Arrhythmias; Cardiac; Cardiomyopathies.