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Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2017; 9(10): 773-786
Published online Oct 26, 2017. doi: 10.4330/wjc.v9.i10.773
Cardiac magnetic resonance imaging: Which information is useful for the arrhythmologist?
Elia De Maria, Annachiara Aldrovandi, Ambra Borghi, Letizia Modonesi, Stefano Cappelli
Elia De Maria, Annachiara Aldrovandi, Ambra Borghi, Letizia Modonesi, Stefano Cappelli, Cardiology Unit, Ramazzini Hospital, 41012 Carpi (Modena), Italy
Author contributions: De Maria E and Aldrovandi A contributed to concept/design, data analysis/interpretation, manuscript drafting, critical revision and approval; Borghi A, Modonesi L and Cappelli S contributed to manuscript drafting, critical revision and approval.
Conflict-of-interest statement: No potential conflicts of interest exist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Elia De Maria, MD, PhD, Chief of Arrhythmology Lab, Cardiology Unit, Ramazzini Hospital, Via Molinari 1, 41012 Carpi (Modena), Italy. e.demaria@inwind.it
Telephone: +39-5-9659320 Fax: +39-5-9659387
Received: April 12, 2017
Peer-review started: April 16, 2017
First decision: May 9, 2017
Revised: May 23, 2017
Accepted: June 12, 2017
Article in press: June 13, 2017
Published online: October 26, 2017
Processing time: 193 Days and 7.2 Hours
Abstract

Cardiac magnetic resonance (CMR) is a non-invasive, non-ionizing, diagnostic technique that uses magnetic fields, radio waves and field gradients to generate images with high spatial and temporal resolution. After administration of contrast media (e.g., gadolinium chelate), it is also possible to acquire late images, which make possible the identification and quantification of myocardial areas with scar/fibrosis (late gadolinium enhancement, LGE). CMR is currently a useful instrument in clinical cardiovascular practice for the assessment of several pathological conditions, including ischemic and non-ischemic cardiomyopathies and congenital heart disease. In recent years, its field of application has also extended to arrhythmology, both in diagnostic and prognostic evaluation of arrhythmic risk and in therapeutic decision-making. In this review, we discuss the possible useful applications of CMR for the arrhythmologist. It is possible to identify three main fields of application of CMR in this context: (1) arrhythmic and sudden cardiac death risk stratification in different heart diseases; (2) decision-making in cardiac resynchronization therapy device implantation, presence and extent of myocardial fibrosis for left ventricular lead placement and cardiac venous anatomy; and (3) substrate identification for guiding ablation of complex arrhythmias (atrial fibrillation and ventricular tachycardias).

Keywords: Cardiac magnetic resonance, Ablation, Sudden cardiac death, Cardiac resynchronization therapy, Arrhythmic risk stratification

Core tip: Cardiac magnetic resonance (CMR) is a non-ionizing diagnostic technique that generates images with high spatial and temporal resolution. After administration of contrast media (e.g., gadolinium chelate), it is also possible to acquire late images, which make possible the identification and quantification of myocardial areas with scar/fibrosis (late gadolinium enhancement). In recent years, its field of application has extended to arrhythmology, both in diagnostic and prognostic evaluation of arrhythmic risk and in therapeutic decision-making. In this review, we discuss the applications of CMR for the arrhythmologist. It is possible to identify three main fields of application in this context: (1) arrhythmic and sudden cardiac death risk stratification; (2) decision making in cardiac resynchronization therapy device implantation; and (3) substrate identification for guiding ablation of complex arrhythmias.