Abstract
The aim of the study was to assess the role of cardiovascular magnetic resonance (CMR) in the diagnosis of idiopathic VA in children. This retrospective single-centre study included a total of 80 patients with idiopathic ventricular arrhythmia that underwent routine CMR imaging between 2016 and 2020 at our institution. All patients underwent a 3.0 T scan involving balanced steady-state free precession cine images as well as dark-blood T2W images and assessment of late gadolinium enhancement (LGE). In 26% of patients (n = 21) CMR revealed cardiac abnormalities, in 20% (n = 16) not suspected on prior echocardiography. The main findings included: non-ischemic ventricular scars (n = 8), arrhythmogenic right ventricular cardiomyopathy (n = 6), left ventricular clefts (n = 4) and active myocarditis (n = 3). LGE was present in 57% of patients with abnormal findings. Univariate predictors of abnormal CMR result included abnormalities in echocardiography and severe VA (combination of >10% of 24 h VA burden and/or presence of ventricular tachycardia and/or polymorphic VA). CMR provides valuable clinical information in many cases of idiopathic ventricular arrhythmia in children, mainly due to its advanced tissue characterization capabilities and potential to assess the right ventricle.
Highlights
Ventricular arrhythmia (VA) is a prominent problem in the field of paediatric cardiology
Identifying the substrate of arrhythmia has been a goal of many studies published throughout the course of recent years, many of which promote the role of cardiovascular magnetic resonance (CMR) in this diagnostic process, due to its capability to localize the source of electrical instability as well as a mean of guiding the electrophysiological treatment [6,7,8]
Our single-centre study was a retrospective analysis of 80 consecutive children suffering from supposedly idiopathic VA in whom CMR was performed between April 2016 and January 2020 due to clinical indications described below
Summary
Ventricular arrhythmia (VA) is a prominent problem in the field of paediatric cardiology. Identifying the substrate of arrhythmia has been a goal of many studies published throughout the course of recent years, many of which promote the role of CMR in this diagnostic process, due to its capability to localize the source of electrical instability as well as a mean of guiding the electrophysiological treatment [6,7,8]. All of these studies were conducted on adult subjects and addressed mainly late gadolinium enhancement (LGE) and its role in tissue characterization in the search for aetiology of myocardial injury [9,10]. The aim of our study was to assess the role of CMR in identifying underlying structural heart disease and its role as a potential substrate of VA considered as idiopathic in paediatric population
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