1008 Contrast enhanced cardiovascular magnetic resonance imaging prior to prophylactic implantation of a cardioverter/de
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Meeting abstract
1008 Contrast enhanced cardiovascular magnetic resonance imaging prior to prophylactic implantation of a cardioverter/defibrillator identifies patients with increased risk for ventricular arrhythmias Philipp Boyé*1, Udo Zacharzowsky2, Hassan Abdel-Aty1, Alexander Schirdewan2, Rainer Dietz3 and Jeanette Schulz-Menger1 Address: 1Cardiac MRI Team, Charité University Berlin, Berlin, Germany, 2Department of Electrophysiology, Charité University Berlin, Berlin, Germany and 3Franz Volhard Clinic, Charité University Berlin, Berlin, Germany * Corresponding author
from 11th Annual SCMR Scientific Sessions Los Angeles, CA, USA. 1–3 February 2008 Published: 22 October 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A133
doi:10.1186/1532-429X-10-S1-A133
Abstracts of the 11th Annual SCMR Scientific Sessions - 2008
Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/pdf/1532-429X-10-S1-info.pdfThis abstract is available from: http://jcmr-online.com/content/10/S1/A133 © 2008 Boyé et al; licensee BioMed Central Ltd.
Prophylactic implantation of a cardioverter/defibrillator (ICD) has been shown to reduce mortality in patients with chronic myocardial infarction (CMI) and an increased risk for life threatening ventricular arrhythmia (VA). VA is related to infarct size and seems to be related to infarct morphology. Contrast enhanced cardiovascular magnetic resonance imaging (ceCMR) can detect and quantify myocardial fibrosis in the setting of CMI and might therefore be a valuable tool for more accurate risk stratification in this setting.
defined by transmural to non-transmural extent in each scar (sequence: inversion recovery gradient echo; matrix 256 × 148, imaging 10–30 min after 0.2 μg/kg gadolinium DTPA; short axis stack; full coverage of the LV, no gap; slice thickness 6 mm). After implantation, patients were followed up including ICD readout after 3 and than every 6 months for a mean of 692 ± 292 days. ICD data were evaluated by an experienced electrophysiologist. Primary endpoint was the occurrence of an appropriate discharge (DC), antitachycard pacing (ATP) or death from cardiac cause.
Purpose
Results
ceCMR can identify the subgroup developing VA in patients with prophylactic ICD implantation following MADIT criteria.
The endpoint occurred in 9 cases (5 DC, 3 ATP, 1 death). There was no significant association between the endpoint and LVEF (31 ± 9 vs. 31 ± 11, p = 0.97), total infarct mass (50 ± 19 vs 53 ± 34 g, p = 0.78) or infarct size related to left ventricular mass (29 ± 6% vs. 30 ± 16, p = 0.87). The degree of transmurality was significantly associated with the occurrence of the endpoint. Scars with mainly transmural (> 75%) or strictly subendocardial extent (< 50%) were less likely to show ventricular arrhythmia than scars with a transmural extent of 50–75% (Chi-Square p = 0.035).
Introduction
Methods We prospectively enrolled 50 patients (47 males, age
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