Cardiac magnetic resonance imaging in patients with premature ventricular complexes or non-sustained ventricular tachycardia: real-world experience

Document Type

Conference Proceeding

Publication Date

11-5-2025

Publication Title

Eur Heart J

Keywords

gadolinium, adult, aged, cardiac sarcoidosis, cardiologist, cardiomyopathy, cardiovascular magnetic resonance, cohort analysis, comorbidity, conference abstract, data analysis software, diabetes mellitus, diagnosis, drug therapy, electrocardiography, electronic medical record, female, granulomatosis, heart failure, Holter monitor, human, hypertension, ICD-10, major clinical study, male, medical record review, middle aged, paroxysmal supraventricular tachycardia, prematurity, prevalence, probability, retrospective study, sarcoidosis, telemetry

Abstract

Introduction: Patients with premature ventricular complexes (PVCs) or non-sustained ventricular tachycardia (NSVT) frequently undergo cardiac MRI (cMRI) to determine the etiology but the exact utility in real world remains unknown. Its use is limited due to high cost, limited accessibility, and expertise needed in interpretation. We describe real world experience with clinical utility of cMRI among patients with PVCs or NSVT. Methods: We did a retrospective chart review of all patients who underwent cMRI for PVCs or NSVT between 2012-2023 in a single health system. The study was approved by the institutional review board. The outcome was presence of pathologic late gadolinium enhancement (LGE) on cMRI. Right ventricular insertion point LGE in isolation was excluded. Demographic and clinical variables were collected using ICD-10 codes in the electronic medical record. Cardiac sarcoidosis was diagnosed by a multidisciplinary team consisting of a board-certified cardiologist and pulmonologist using the World Association of Sarcoidosis and Other Granulomatous Diseases (WASOG) definitions: highly probable (>90% probability of CS), probable (50-90% probability of CS), and possible (<50% probability of CS). All statistical analysis was performed with SPSS software (IBM, Armonk, NY, USA). Results: Among 553 patients, the mean age was 61.1 (SD 14.6) years, and 40.7% female. Prevalence of hypertension, heart failure, and diabetes was 55.7%, 35.6% and 21.0%, respectively. Prevalence of sarcoidosis was 4.9%, >99% involving the lung. PVCs/NSVT were diagnosed with EKG in 40.9%, Holter Monitor in 35.8%, telemetry in 19.0%, event monitor in 9.9% and implantable loop recorder in 1.8%. Pathologic LGE was found in 214 patients (38.6%). Patients with pathologic LGE were older with higher burden of co-morbidities (Table). Among those with LGE, highly probable cardiac sarcoidosis was diagnosed in 12.6% patients using the WASOG criteria. The other etiology of PVC/ NSVT in those with LGE was unspecified cardiomyopathy in 53.7%, idiopathic in 22.0% and ischemic in 11.7%. Among those without LGE, unspecified cardiomyopathy was the diagnosis in 34.5%, idiopathic in 60.5%, ischemic in 3.2% and highly probable cardiac sarcoidosis in 1.8%. Conclusion: In this real-world study, we describe the use of cMRI among patients with PVCs or NSVT. Around 40% patients in our cohort had LGE, and an etiology of PVCs or NSVT was identifiable in 1 in 3 of these patients. This knowledge can help select future patients who may benefit from cMRI.

Volume

46

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