Clinical utility of cardiovascular magnetic resonance imaging in patients with implantable cardioverter defibrillators presenting with electrical instability or worsening heart failure symptoms.

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  • Additional Information
    • Affiliation:
      Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Background: Data on the usefulness of cardiovascular magnetic resonance (CMR) imaging for clinical decision making in patients with an implanted cardioverter defibrillator (ICD) are scarce. The present study determined the impact of CMR imaging on diagnostic stratification and treatment decisions in ICD patients presenting with electrical instability or progressive heart failure symptoms. Methods: 212 consecutive ICD patients underwent 1.5 T CMR combining diagnostic imaging modules tailored to the individual clinical indication (ventricular function assessment, myocardial tissue characterization, adenosine stress-perfusion, 3D-contrast-enhanced angiography); four CMR examinations (4/212, 2%) were excluded due to non-diagnostic CMR image quality. The resultant change in diagnosis or clinical management was determined in the overall population and compared between ICD patients for primary (115/208, 55%) or secondary prevention (93/208, 45%). Referral indication consisted of documented ventricular tachycardia, inadequate device therapy or progressive heart failure symptoms. Results: Overall, CMR imaging data changed diagnosis in 40% (83/208) with a significant difference between primary versus secondary prevention ICD patients (37/115, 32% versus 46/93, 49%, respectively; p = 0.01). The information gain from CMR led to an overall change in treatment in 21% (43/208) with a similar distribution in primary versus secondary prevention ICD patients (25/115,22% versus 18/93,19%, p = 0.67). The effect on treatment change was highest in patients initially scheduled for ventricular tachycardia ablation procedure (18/141, 13%) with revision of the treatment plan to medical therapy or coronary revascularization. Conclusions: CMR imaging in ICD patients presenting with electrical instability or worsening heart failure symptoms provided diagnostic or management-changing information in a considerable proportion (40% and 21%, respectively).
    • Journal Subset:
      Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; UK & Ireland
    • ISSN:
      1532-429X
    • MEDLINE Info:
      NLM UID: 9815616
    • Publication Date:
      20200513
    • Publication Date:
      20200514
    • DOI:
      http://dx.doi.org/10.1186/s12968-020-00609-z
    • Accession Number:
      143136287
  • Citations
    • ABNT:
      LINDEMANN, F. et al. Clinical utility of cardiovascular magnetic resonance imaging in patients with implantable cardioverter defibrillators presenting with electrical instability or worsening heart failure symptoms. Journal of Cardiovascular Magnetic Resonance (BioMed Central), [s. l.], v. 22, n. 1, p. 1–12, 2020. DOI 10.1186/s12968-020-00609-z. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143136287. Acesso em: 13 ago. 2020.
    • AMA:
      Lindemann F, Oebel S, Paetsch I, et al. Clinical utility of cardiovascular magnetic resonance imaging in patients with implantable cardioverter defibrillators presenting with electrical instability or worsening heart failure symptoms. Journal of Cardiovascular Magnetic Resonance (BioMed Central). 2020;22(1):1-12. doi:10.1186/s12968-020-00609-z
    • APA:
      Lindemann, F., Oebel, S., Paetsch, I., Arya, A., Dagres, N., Richter, S., Dinov, B., Hilbert, S., Loebe, S., Stegmann, C., Doering, M., Bollmann, A., Hindricks, G., & Jahnke, C. (2020). Clinical utility of cardiovascular magnetic resonance imaging in patients with implantable cardioverter defibrillators presenting with electrical instability or worsening heart failure symptoms. Journal of Cardiovascular Magnetic Resonance (BioMed Central), 22(1), 1–12. https://doi.org/10.1186/s12968-020-00609-z
    • Chicago/Turabian: Author-Date:
      Lindemann, Frank, Sabrina Oebel, Ingo Paetsch, Arash Arya, Nikolaos Dagres, Sergio Richter, Borislav Dinov, et al. 2020. “Clinical Utility of Cardiovascular Magnetic Resonance Imaging in Patients with Implantable Cardioverter Defibrillators Presenting with Electrical Instability or Worsening Heart Failure Symptoms.” Journal of Cardiovascular Magnetic Resonance (BioMed Central) 22 (1): 1–12. doi:10.1186/s12968-020-00609-z.
    • Harvard:
      Lindemann, F. et al. (2020) ‘Clinical utility of cardiovascular magnetic resonance imaging in patients with implantable cardioverter defibrillators presenting with electrical instability or worsening heart failure symptoms’, Journal of Cardiovascular Magnetic Resonance (BioMed Central), 22(1), pp. 1–12. doi: 10.1186/s12968-020-00609-z.
    • Harvard: Australian:
      Lindemann, F, Oebel, S, Paetsch, I, Arya, A, Dagres, N, Richter, S, Dinov, B, Hilbert, S, Loebe, S, Stegmann, C, Doering, M, Bollmann, A, Hindricks, G & Jahnke, C 2020, ‘Clinical utility of cardiovascular magnetic resonance imaging in patients with implantable cardioverter defibrillators presenting with electrical instability or worsening heart failure symptoms’, Journal of Cardiovascular Magnetic Resonance (BioMed Central), vol. 22, no. 1, pp. 1–12, viewed 13 August 2020, .
    • MLA:
      Lindemann, Frank, et al. “Clinical Utility of Cardiovascular Magnetic Resonance Imaging in Patients with Implantable Cardioverter Defibrillators Presenting with Electrical Instability or Worsening Heart Failure Symptoms.” Journal of Cardiovascular Magnetic Resonance (BioMed Central), vol. 22, no. 1, May 2020, pp. 1–12. EBSCOhost, doi:10.1186/s12968-020-00609-z.
    • Chicago/Turabian: Humanities:
      Lindemann, Frank, Sabrina Oebel, Ingo Paetsch, Arash Arya, Nikolaos Dagres, Sergio Richter, Borislav Dinov, et al. “Clinical Utility of Cardiovascular Magnetic Resonance Imaging in Patients with Implantable Cardioverter Defibrillators Presenting with Electrical Instability or Worsening Heart Failure Symptoms.” Journal of Cardiovascular Magnetic Resonance (BioMed Central) 22, no. 1 (May 11, 2020): 1–12. doi:10.1186/s12968-020-00609-z.
    • Vancouver/ICMJE:
      Lindemann F, Oebel S, Paetsch I, Arya A, Dagres N, Richter S, et al. Clinical utility of cardiovascular magnetic resonance imaging in patients with implantable cardioverter defibrillators presenting with electrical instability or worsening heart failure symptoms. Journal of Cardiovascular Magnetic Resonance (BioMed Central) [Internet]. 2020 May 11 [cited 2020 Aug 13];22(1):1–12. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143136287