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Diagnostics
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Imaging Cardiac Arrhythmia/Sudden Cardiac Death 2.0
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Imaging Cardiac Arrhythmia/Sudden Cardiac Death 2.0

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 March 2023) | Viewed by 13911

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 completely abolish these events. 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. These are 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/opinion 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

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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 (6 papers)

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Research

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13 pages, 3586 KiB  
Article
Pulmonary Veins Morphometric Characteristics and Spatial Orientation Influence on Its Cryoballoon Isolation Results
by Sergey Mamchur, Tatiana Chichkova, Egor Khomenko and Alexander Kokov
Diagnostics 2022, 12(6), 1322; https://doi.org/10.3390/diagnostics12061322 - 26 May 2022
Cited by 4 | Viewed by 1798
Abstract
The aim of this paper is to evaluate the effect of pulmonary vein (PV) morphometric characteristics and spatial orientation on the results of cryoballoon ablation (CBA). Methods: A randomized, prospective, single-center controlled study was conducted, enrolling 230 patients with drug-refractory atrial fibrillation (AF). [...] Read more.
The aim of this paper is to evaluate the effect of pulmonary vein (PV) morphometric characteristics and spatial orientation on the results of cryoballoon ablation (CBA). Methods: A randomized, prospective, single-center controlled study was conducted, enrolling 230 patients with drug-refractory atrial fibrillation (AF). We compared procedural and long-term outcomes in patients who underwent their first procedure of pulmonary vein isolation (PVI) for AF with either radiofrequency ablation (RFA) (n = 108) or CBA (n = 122) and assessed their interaction with the different pattern of PV anatomy, morphometric characteristics, and spatial orientation. The primary efficacy endpoint was any documented atrial arrhythmia recurrence (AF, atrial flutter, or atrial tachycardia) lasting over 30 s during a 12-month follow-up after a 90-day blanking period and discontinuation of antiarrhythmic drugs. The procedure’s endpoint was the achievement of PVI. Before the intervention, all patients underwent computed tomography (CT) to assess the PV anatomical variant, maximum and minimum diameters of the PV’s ostia, their cross-sectional area, orifice ovality index, and PV tilt angles. Results: The mean follow-up period was 14 months (12; 24). Long-term efficacy in the cryoablation group was 78.8% and in the RFA group—83.3% (OR = 0.74; 95% CI 0.41–1.3; p = 0.31). The RFA results did not depend on PV anatomy. The «difficult» occlusion of the right inferior PV (RIPV) occurred in 12 patients and was associated with a more horizontal PV position in the frontal plane; the mean tilt angle was −15.2 ± 6.2° versus −26.5 ± 6.3° in the absence of technical difficulties (p = 0.0001). In 11 cases (9%), during ablation of the right superior PV (RSPV), phrenic nerve injury (PNI) occurred and was associated with the maximum and minimum RSPV diameter, 20.0–20.4 mm (OR = 13.2; 95% CI: 4.7–41.9, p < 0.05) and 17.5–20 mm (OR = 12.5; 95% CI 3.4–51, p < 0.05), respectively. Patients with arrhythmia recurrence were characterized by significantly larger diameters and ovality of the left superior PV (LSPV). The spatial orientation of the PV does not affect the long-term results of cryoablation. Conclusion: Preprocedural evaluation of PV morphology and orientation using cardiac CT might help choose the optimal technology for the individual patient. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death 2.0)
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Review

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10 pages, 1701 KiB  
Review
Behind Enemy Lines: Vital Echocardiographic Data Prior to Ventricular Arrhythmia Ablation
by Silvia Deaconu, Alexandru Deaconu, Gabriela Marascu, Ioana Petre and Radu Vatasescu
Diagnostics 2022, 12(9), 2109; https://doi.org/10.3390/diagnostics12092109 - 31 Aug 2022
Viewed by 1540
Abstract
Ventricular arrhythmias (VA) are a major cause of sudden cardiac death (SCD). Echocardiography is the first widely available imaging tool which guides VA management strategies. Along with other invasive and noninvasive imaging techniques, it provides essential information for identification of VA substrate such [...] Read more.
Ventricular arrhythmias (VA) are a major cause of sudden cardiac death (SCD). Echocardiography is the first widely available imaging tool which guides VA management strategies. Along with other invasive and noninvasive imaging techniques, it provides essential information for identification of VA substrate such as differentiation between ischemic and non-ischemic etiology and identification of structural heart disease. Both classic as well as novel echocardiographic techniques such as left ventricular strain measurement and mechanical dispersion assessment provide prognostic information and assist in risk stratification. Furthermore, intracardiac echocardiography may have an adjunctive role for the VA ablation by providing real-time visualization of cardiac structures, continuous monitoring of catheter location and early recognition of procedural complications. This review gathers all relevant information that echocardiography may offer prior to VA ablation procedures. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death 2.0)
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17 pages, 1185 KiB  
Review
Assessment of Left Atrial Structure and Function by Echocardiography in Atrial Fibrillation
by Mengmeng Ji, Lin He, Lang Gao, Yixia Lin, Mingxing Xie and Yuman Li
Diagnostics 2022, 12(8), 1898; https://doi.org/10.3390/diagnostics12081898 - 5 Aug 2022
Cited by 4 | Viewed by 3624
Abstract
Atrial fibrillation (AF) is the most common arrhythmia with significant morbidity and mortality. Exacerbated by the aging population, the prevalence of AF is gradually increasing. Accurate evaluation of structure and function of left atrium (LA) has important prognostic significance in patients with AF. [...] Read more.
Atrial fibrillation (AF) is the most common arrhythmia with significant morbidity and mortality. Exacerbated by the aging population, the prevalence of AF is gradually increasing. Accurate evaluation of structure and function of left atrium (LA) has important prognostic significance in patients with AF. Echocardiography is the imaging technique of first choice to assess LA structure and function due to its better availability, accessibility and safety over cardiac computed tomography and cardiac magnetic resonance. Therefore, the aim of this review is to summarize the recent research progress of evaluating LA size by three-dimensional echocardiography and LA function by speckle tracking echocardiography (STE) in predicting the occurrence and recurrence of AF and determining the risk of stroke in AF. In addition, we summarized the role of traditional echocardiography in detecting AF patients that are at high risk of heart failure or cardiovascular death. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death 2.0)
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Other

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7 pages, 2279 KiB  
Interesting Images
Single Coronary Artery as a Rare Developmental Variant in Cardiac Computed Tomography Angiography
by Paweł Gać, Agnieszka Trejtowicz-Sutor and Rafał Poręba
Diagnostics 2023, 13(8), 1369; https://doi.org/10.3390/diagnostics13081369 - 7 Apr 2023
Viewed by 1608
Abstract
Cardiac computed tomography angiography (CCTA) is a non-invasive method for the diagnosis of coronary artery disease. In addition to the assessment of possible stenoses in the coronary arteries, this method also allows the assessment of other abnormalities of coronary and extracoronary heart structures. [...] Read more.
Cardiac computed tomography angiography (CCTA) is a non-invasive method for the diagnosis of coronary artery disease. In addition to the assessment of possible stenoses in the coronary arteries, this method also allows the assessment of other abnormalities of coronary and extracoronary heart structures. CCTA is the optimal method for assessing the relationship of coronary arteries to other anatomical structures; thus, it is used as a method of diagnosing developmental variants of coronary circulation. We present images of a single left coronary artery in a 384-slice CCTA in a 69-year-old Caucasian female patient with non-specific chest pain and low intermediate cardiovascular risk as an example of a rare developmental coronary variant. In conclusion, the importance of CCTA as a method of diagnosing developmental variations of the heart and vessels should be emphasized. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death 2.0)
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5 pages, 1657 KiB  
Interesting Images
Coexistence of Cor Triatriatum Sinister, Fibroelastoma and Pulmonary Veins Ostial Anatomy Variant as Incidental Findings in Coronary Computed Tomography Angiography
by Paweł Gać, Adrian Martuszewski, Patrycja Paluszkiewicz and Rafał Poręba
Diagnostics 2022, 12(6), 1449; https://doi.org/10.3390/diagnostics12061449 - 13 Jun 2022
Viewed by 1854
Abstract
Coronary computed tomography angiography (CCTA) is a noninvasive examination whose main purpose is to exclude significant stenosis in the coronary arteries. The obtained computed tomography images may also provide information about other coexisting pathologies of the heart and vessels. The paper presents images [...] Read more.
Coronary computed tomography angiography (CCTA) is a noninvasive examination whose main purpose is to exclude significant stenosis in the coronary arteries. The obtained computed tomography images may also provide information about other coexisting pathologies of the heart and vessels. The paper presents images of cardiac lesions in a 44-year-old hypertensive patient who underwent CCTA, based on which significant stenosis in the coronary arteries was excluded, the suspicion of a cor triatriatum sinister was confirmed and the presence of fibroelastoma and a variant of the anatomy of the pulmonary veins ostial was confirmed. To sum up, when performing CCTA, apart from the analysis of the coronary arteries, one should remember about lesions in the remaining visible anatomical structures of the heart and large vessels. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death 2.0)
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8 pages, 1210 KiB  
Case Report
A Single Coronary Artery Originating from the Right Coronary Sinus with a Typical Course of the Right Coronary Artery and the Interarterial Course of the Left Main, Left Anterior Descending, and Left Circumflex as an Example of a Rare Case of High-Risk Coronary Anomaly
by Paweł Gać, Aleksandra Żórawik and Rafał Poręba
Diagnostics 2022, 12(1), 167; https://doi.org/10.3390/diagnostics12010167 - 11 Jan 2022
Cited by 1 | Viewed by 2803
Abstract
In the typical course of the coronary arteries, the right coronary artery comes from the right coronary sinus and descends in the right atrioventricular groove. The left coronary artery trunk begins from the left coronary sinus. It crosses the pulmonary trunk and divides [...] Read more.
In the typical course of the coronary arteries, the right coronary artery comes from the right coronary sinus and descends in the right atrioventricular groove. The left coronary artery trunk begins from the left coronary sinus. It crosses the pulmonary trunk and divides into left anterior descending and left circumflex arteries. Anatomical differences of the coronary arteries can be observed in 0.3–5.6% of the population. The interarterial course of coronary branches between the aorta and the pulmonary trunk is a malignant anomaly of the coronary arteries. Such abnormalities have been associated with an increased risk of sudden cardiac death. We present a rare case of coronary arteries anomaly involving the presence of a single right coronary artery and the interarterial course of its atypical branches documented by computed tomography angiography (CTA). In summary, the accurate assessment of the anatomical topography of coronary anomalies, possible in CTA, is necessary in the analysis of the risk of sudden cardiac death and its prevention. Full article
(This article belongs to the Special Issue Imaging Cardiac Arrhythmia/Sudden Cardiac Death 2.0)
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