Using cardiac magnetic resonance feature tracking to discover novel abnormalities in patients with idiopathic ventricular fibrillation

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Abstract Background Despite an extensive diagnostic work-up, the underlying diagnosis leading to ventricular fibrillation (VF) remains elusive in patients with idiopathic VF. Emerging diagnostic techniques can be used to discover previously unidentified abnormalities in these patients. Purpose The purpose of this study was to investigate the potential of cardiac magnetic resonance feature tracking (CMR-FT) to discover structural abnormalities in idiopathic VF patients. Methods Cine CMR images of idiopathic VF patients and age and sex matched controls were analyzed. Left ventricle global circumferential strain (GCS), global longitudinal strain (GLS) and global radial strain (GRS) were determined using Circle Cardiovascular Imaging. Student’s t-test was used to compare means. Results In total, 26 idiopathic VF patients (mean age 37 (±13) years, 62% male) and 26 controls (mean age 38 (±13) years) were included. CMR was performed in idiopathic VF patients at a median of 9 [IQR 3 – 15] days after the index event. Left ventricle ejection fraction was 55 ± 6% for idiopathic VF patients, 59 ± 6% for controls, p = 0.04. GCS and GRS were comparable for idiopathic VF patients and controls (-17.36 ± 1.78% vs. -18.04 ± 1.83%, p = 0.182 and 28.28 ± 4.63 vs. 29.29 ± 5.09, p = 0.438, respectively). GLS was lower for idiopathic VF patients compared with controls (-14.85 ± 3.21% vs. -18.44 ± 2.11%, p < 0.001). Conclusion CMR-FT GLS distinguished idiopathic VF patients from controls and could imply subclinical abnormalities in idiopathic VF patients. Future studies with a larger cohort should reveal if this finding can be correlated with an arrhythmic substrate.