Review Article

Imaging of patients with implanted devices and arrhythmia

Nam Ju Lee, Harold I. Litt
South African Journal of Radiology | Vol 20, No 2 | a1046 | DOI: https://doi.org/10.4102/sajr.v20i2.1046 | © 2016 Nam Ju Lee, Harold I. Litt | This work is licensed under CC Attribution 4.0
Submitted: 06 June 2016 | Published: 11 November 2016

About the author(s)

Nam Ju Lee, Department of Radiology and Radiological Science, Johns Hopkins University, United States
Harold I. Litt, Department of Radiology, University of Pennsylvania, United States

Abstract

Expanding implantable cardioverter-defibrillator (ICD) indications and significant morbidity and mortality reduction benefits have resulted in a large number of routine ICD implants with appropriate ICD shocks for ventricular arrhythmias. The side-effects and lack of long-term efficacy of antiarrhythmics have made ventricular tachycardia (VT) ablation an increasingly attractive treatment option. Although cardiac magnetic resonance imaging (CMR) is considered the gold standard technique for imaging of myocardial fibrosis to diagnose and guide VT ablation targets in patients with cardiac arrhythmia, safety concerns and significant artifacts from the devices significantly limit the application of CMR. We discuss how to decrease artifact from cardiac devices and the role of a modified inversion pulse late gadolinium enhancement (LGE) CMR sequence as a useful tool in this setting, and we review techniques, safety protocols and limitations from the perspective of our institution’s experience.

Keywords

cardiac magnetic resonance; implanted cardiac devices

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Crossref Citations

1. Metal Artifact Reduction in Cardiovascular MRI for Accurate Myocardial Scar Assessment in Patients With Cardiac Implantable Electronic Devices
Mason Runge, El-Sayed H. Ibrahim, Frank Bogun, Anil Attili, Maryam Ghadimi Mahani, Yuxi Pang, Laura Horwood, Thomas L. Chenevert, Jadranka Stojanovska
American Journal of Roentgenology  vol: 213  issue: 3  first page: 555  year: 2019  
doi: 10.2214/AJR.19.21187