Applications of cardiac magnetic resonance in electrophysiology

Abstract

Contemporary methods for evaluation and treatment of arrhythmia are increasingly dependent upon characterization of the underlying myocardial substrate. Cardiovascular magnetic resonance offers unsurpassed soft tissue resolution capable of visualizing detailed cardiac anatomic features and intra-myocardial barriers to conduction. Non-invasive visualization of such anatomic detail has the potential to improve methods to diagnose, risk stratify, and treat patients with arrhythmia. This review describes a brief overview of the current knowledge on the applications of cardiac magnetic resonance for evaluation and treatment of patients with arrhythmia.

Conflict of interest statement

Disclosures

Dr Halperin serves as scientific advisor for Boston Scientific Inc. and holds a patent on MRI compatible catheter technology. Dr Bluemke has received honoraria from General Electric Healthcare for lectures. The Johns Hopkins University Advisory Committee on Conflict of Interest manages all commercial arrangements.

Figures

Figure 1

The figure illustrates LGE images in cardiomyopathies and delayed enhancement patterns (arrows). A) Hypertrophic cardiomyopathy, B) idiopathic cardiomyopathy, C) sarcoidosis, D) ARVD.

Figure 2

Transverse inversion recovery gradient echo images of the left atrium obtained by Peters et al, showing no LGE pre-ablation (left panel), in comparison to post ablation images (right panel) with LGE noted in the pulmonary vein ostial region where radiofrequency energy was delivered.

Figure 3

The figure is a 3 dimensional processed LGE image of a patient with ischemic cardiomyopathy. Scar has been highlighted in red. The yellow curved arrows show potential pathways for reentry.