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Risk Stratification Beyond Left Ventricular Ejection Fraction: Role of Cardiovascular Magnetic Resonance

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Clinical Controversies in Device Therapy for Cardiac Arrhythmias

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Abstract

Sudden cardiac death (SCD) is a major health problem worldwide. The majority of cases are due to ventricular tachycardia (VT) or ventricular fibrillation (VF). The left ventricular ejection fraction (LVEF) has been adopted as a criterion for the risk stratification of patients at risk of SCD and for the prescription of implantable cardioverter defibrillator (ICD) therapy. However, most patients succumbing to SCD fall outside current indications for primary prevention ICD implantation and most ICD recipients do not receive therapy from the device. Cardiovascular magnetic resonance (CMR), the gold standard for the characterization of myocardial phenotypes, can identify myocardial scar, a substrate of ventricular arrhythmias. This review focuses on how CMR can contribute to the arrhythmic risk stratification and how it may help in selecting patients for an ICD.

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Authors and Affiliations

  1. Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, UK

    Francisco Leyva

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  1. Francisco Leyva
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Correspondence to Francisco Leyva .

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Editors and Affiliations

  1. University of Rochester School of Medicine & Dentistry/Hackensack Meridian, School of Medicine at Seton Hall, University/Summit Medical Group, Short Hills, NJ, USA

    Jonathan S. Steinberg

  2. Electrophysiology Section, Cardiovascular Division, Univeristy of Pennsylvania, and the Cardiology Division, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA

    Andrew E. Epstein

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Leyva, F. (2019). Risk Stratification Beyond Left Ventricular Ejection Fraction: Role of Cardiovascular Magnetic Resonance. In: Steinberg, J., Epstein, A. (eds) Clinical Controversies in Device Therapy for Cardiac Arrhythmias . Springer, Cham. https://doi.org/10.1007/978-3-030-22882-8_2

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  • DOI: https://doi.org/10.1007/978-3-030-22882-8_2

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