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Diagnostics
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Imaging Cardiac Arrhythmia/Sudden Cardiac Death—3rd Edition
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Imaging Cardiac Arrhythmia/Sudden Cardiac Death—3rd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 May 2024) | Viewed by 9801

Special Issue Editor

Prof. Dr. Sophie Mavrogeni

E-Mail Website
Guest Editor
Department of Cardiology, Onassis Cardiac Surgery Center, 17674 Athens, Greece
Interests: genes in genetic and inflammatory cardiomyopathies; imaging in genetic and inflammatory cardiomyopathies; brain and heart in genetic and inflammatory cardiomyopathies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Myocardial infarction, myocarditis, cardiomyopathies, and congenital heart disease may present with ventricular tachycardia/fibrillation (VT/VF) and/or atrial flutter/fibrillation (af/AF). Although implantable cardioverter defibrillators offer the best protection against sudden cardiac death (SCD), catheter ablation for VT or AF suppression can modify or prevent these events from occurring. However, in order to achieve a successful ablation, the correct identification of the underlying arrhythmogenic substrate is necessary. For this reason, various imaging modalities have been used, including electroanatomic mapping, cardiovascular magnetic resonance imaging, echocardiography, nuclear techniques, and cardiac computed tomography.

The aim of this Special Issue is to present the role of each modality and to further clarify what the most efficient imaging combination is in the assessment of arrhythmogenic substrate. Our target is to provide new knowledge and promote discussions between all experts who are interested in presenting their results/opinions on this topic. Research papers, case reports, case series, exciting images, clinical vignettes, reviews, debates, or current opinions are welcome.

We look forward to receiving your contribution.

Prof. Dr. Sophie Mavrogeni
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ventricular tachycardia/fibrillation
  • atrial flutter/fibrillation
  • electroanatomic mapping
  • cardiovascular magnetic resonance
  • echocardiography
  • nuclear techniques
  • cardiac computed tomography
  • interventional CMI in electrophysiology

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Published Papers (4 papers)

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Research

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10 pages, 408 KiB  
Article
Computed Tomography to Exclude Cardiac Thrombus in Atrial Fibrillation—An 11-Year Experience from an Academic Emergency Department
by Sophie Gupta, Martin Lutnik, Filippo Cacioppo, Teresa Lindmayr, Nikola Schuetz, Elvis Tumnitz, Lena Friedl, Magdalena Boegl, Sebastian Schnaubelt, Hans Domanovits, Alexander Spiel, Daniel Toth, Raoul Varga, Marcus Raudner, Harald Herkner, Michael Schwameis and Jan Niederdoeckl
Diagnostics 2024, 14(7), 699; https://doi.org/10.3390/diagnostics14070699 - 27 Mar 2024
Viewed by 1341
Abstract
Background: Computed tomography (CT) could be a suitable method for acute exclusion of left atrial appendage thrombus (LAAT) prior to cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) at the emergency department. Our aim was to present our experiences with this modality [...] Read more.
Background: Computed tomography (CT) could be a suitable method for acute exclusion of left atrial appendage thrombus (LAAT) prior to cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) at the emergency department. Our aim was to present our experiences with this modality in recent years. Methods: This registry-based observational study was performed at the Department of Emergency Medicine at the Medical University of Vienna, Austria. We studied all consecutive patients with AF and AFL who underwent CT between January 2012 and January 2023 to rule out LAAT before cardioversion to sinus rhythm was attempted. Follow-ups were conducted by telephone and electronic medical records. The main variables of interest were the rate of LAAT and ischemic stroke at follow-up. Results: A total of 234 patients (143 [61%] men; median age 68 years [IQR 57–76], median CHA2DS2-VASc 2 [IQR 1–4]) were analyzed. Follow-up was completed in 216 (92%) patients after a median of 506 (IQR 159–1391) days. LAAT was detected in eight patients (3%). A total of 163 patients (72%) in whom LAAT was excluded by CT were eventually successfully cardioverted to sinus rhythm. No adverse events occurred during their ED stay. All patients received anticoagulation according to the CHA2DS2-VASc risk stratification, and no patient had suffered an ischemic stroke at follow-up, resulting in an incidence risk of ischemic strokes of 0% (95% CI 0.0–1.2%). Conclusion: LAAT was rare in patients admitted to the ED with AF and AFL who underwent cardiac CT prior to attempted cardioversion. At follow-up, no patient had suffered an ischemic stroke. Prospective studies need to show whether this strategy is suitable for the acute treatment of symptomatic AF in the emergency setting. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death—3rd Edition)
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13 pages, 1590 KiB  
Article
Enhancing Arrhythmogenic Right Ventricular Cardiomyopathy Detection and Risk Stratification: Insights from Advanced Echocardiographic Techniques
by Natália Olivetti, Luciana Sacilotto, Danilo Bora Moleta, Lucas Arraes de França, Lorena Squassante Capeline, Fanny Wulkan, Tan Chen Wu, Gabriele D’Arezzo Pessente, Mariana Lombardi Peres de Carvalho, Denise Tessariol Hachul, Alexandre da Costa Pereira, José E. Krieger, Mauricio Ibrahim Scanavacca, Marcelo Luiz Campos Vieira and Francisco Darrieux
Diagnostics 2024, 14(2), 150; https://doi.org/10.3390/diagnostics14020150 - 9 Jan 2024
Cited by 2 | Viewed by 1527
Abstract
Introduction: The echocardiographic diagnosis criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC) are highly specific but sensitivity is low, especially in the early stages of the disease. The role of echocardiographic strain in ARVC has not been fully elucidated, although prior studies suggest that [...] Read more.
Introduction: The echocardiographic diagnosis criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC) are highly specific but sensitivity is low, especially in the early stages of the disease. The role of echocardiographic strain in ARVC has not been fully elucidated, although prior studies suggest that it can improve the detection of subtle functional abnormalities. The purposes of the study were to determine whether these advanced measures of right ventricular (RV) dysfunction on echocardiogram, including RV strain, increase diagnostic value for ARVC disease detection and to evaluate the association of echocardiographic parameters with arrhythmic outcomes. Methods: The study included 28 patients from the Heart Institute of São Paulo ARVC cohort with a definite diagnosis of ARVC established according to the 2010 Task Force Criteria. All patients were submitted to ECHO’s advanced techniques including RV strain, and the parameters were compared to prior conventional visual ECHO and CMR. Results: In total, 28 patients were enrolled in order to perform ECHO’s advanced techniques. A total of 2/28 (7%) patients died due to a cardiovascular cause, 2/28 (7%) underwent heart transplantation, and 14/28 (50%) patients developed sustained ventricular arrhythmic events. Among ECHO’s parameters, RV dilatation, measured by RVDd (p = 0.018) and RVOT PSAX (p = 0.044), was significantly associated with arrhythmic outcomes. RV free wall longitudinal strain < 14.35% in absolute value was associated with arrhythmic outcomes (p = 0.033). Conclusion: Our data suggest that ECHO’s advanced techniques improve ARVC detection and that abnormal RV strain can be associated with arrhythmic risk stratification. Further studies are necessary to better demonstrate these findings and contribute to risk stratification in ARVC, in addition to other well-known risk markers. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death—3rd Edition)
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Review

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14 pages, 587 KiB  
Review
Arrhythmic Risk and Treatment after Transcatheter Atrial Septal Defect Closure
by Silvia Deaconu, Alexandru Deaconu, Gabriela Marascu, Mihaela Octavia Stanculescu, Dragoș Cozma, Eliza Cinteza and Radu Vatasescu
Diagnostics 2024, 14(1), 33; https://doi.org/10.3390/diagnostics14010033 - 23 Dec 2023
Cited by 1 | Viewed by 2949
Abstract
Atrial septal defect (ASD) represents the most common congenital heart defect identified in adulthood. Atrial and ventricular geometric remodeling due to intracardiac shunt increase the risk of arrhythmias, especially atrial fibrillation (AF). Clinical, echocardiography, electrocardiogram, and device-related predictors may be used to assess [...] Read more.
Atrial septal defect (ASD) represents the most common congenital heart defect identified in adulthood. Atrial and ventricular geometric remodeling due to intracardiac shunt increase the risk of arrhythmias, especially atrial fibrillation (AF). Clinical, echocardiography, electrocardiogram, and device-related predictors may be used to assess the risk of atrial arrhythmias after ASD closure. The underlying mechanisms in these patients are complex and at least in part independent of the structural remodeling secondary to hemodynamic overload. Device closure of the ASD itself and its timing impact future arrhythmia risk, as well as posing a challenge for when transseptal puncture is required. Sudden cardiac death (SCD) risk is higher than in the general population and an implantable cardioverter-defibrillator (ICD) may be indicated in selected cases. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death—3rd Edition)
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Other

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10 pages, 1926 KiB  
Case Report
Exercise-Induced Arrhythmia or Munchausen Syndrome in a Marathon Runner?
by Robert Gajda, Wojciech Drygas, Jacek Gajda, Pawel Kiper, Beat Knechtle, Magdalena Kwaśniewska, Maciej Sterliński and Elżbieta Katarzyna Biernacka
Diagnostics 2023, 13(18), 2917; https://doi.org/10.3390/diagnostics13182917 - 12 Sep 2023
Cited by 3 | Viewed by 3554
Abstract
A 36-year-old professional marathon runner reported sudden irregular palpitations occurring during competitions, with heart rates (HR) up to 230 bpm recorded on a sports HR monitor (HRM) over 4 years. These episodes subsided upon the cessation of exercise. Electrocardiograms, echocardiography, and cardiac magnetic [...] Read more.
A 36-year-old professional marathon runner reported sudden irregular palpitations occurring during competitions, with heart rates (HR) up to 230 bpm recorded on a sports HR monitor (HRM) over 4 years. These episodes subsided upon the cessation of exercise. Electrocardiograms, echocardiography, and cardiac magnetic resonance imaging results were borderline for athlete’s heart. Because an electrophysiology study and standard exercise tests provoked no arrhythmia, doctors suspected Munchausen syndrome. Ultimately, an exercise test that simulated the physical effort of a competition provoked tachyarrhythmia consistent with the HRM readings. This case demonstrates the diagnostic difficulties related to exercise-induced arrhythmia and the diagnostic usefulness of sports HRMs. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death—3rd Edition)
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