Late Gadolinium Enhancement and Signal Average Electrocardiogram for Predicting Ventricular Tachyarrhythmia

Abstract

Late gadolinium enhancement (LGE) during cardiac magnetic resonance (CMR) is associated with the prevalence of ventricular tachycardia/ventricular fibrillation (VT/VF). Signal average electrocardiogram (SAECG) is also relevant to VT/VF. The purpose of this study was to investigate the clinical significance of LGE and SAECG for patients with organic heart disease. We studied 150 patients with organic heart disease who performed CMR from 2006 to 2011. We examined them about LGE and SAECG for incidence of VT/VF. Their mean age was 62.9 years old, their mean left ventricular ejection fraction was 45.3%, and mean brain natriuretic peptide was 440 pg/ml. Their underlying heart disease were ischemic heart disease (IHD, 46 patients), dilated cardiomyopathy (38 patients), hypertrophic cardiomyopathy (HCM, 38 patients), and others. Ninety-four patients showed LGE in CMR, and 26 patients experienced VT/VF during follow-up of 13.4±9.4 months. In IHD patients, incidence of VT/VF was higher in patients with positive SAECG than patients with negative SAECG (37% vs 9%, p<0.05). In HCM patients, VT/VF occurred more frequently in patients with LGE than patients without LGE (24% vs 0%, p<0.05). In IHD, SAECG is more valuable in predicting tachyarrhythmia event. On the other hand, in HCM, LGE offers more useful information.