Cardiac Imaging in Arrhythmias

Sergiu Batâr 1 , Florina Batâr 2 , Victor Costache 3 , and Ioan Manțiu 4
  • 1 „Lucian Blaga” University Sibiu, , Romania
  • 2 „Lucian Blaga” University Sibiu, , Romania
  • 3 „Lucian Blaga” University Sibiu, , Romania
  • 4 „Lucian Blaga” University Sibiu, , Romania


Cardiac arrhythmias occur frequently in valvular patients. In valvular patients the role of echocardiography is essential, due to prognostic variations. A common indication of CT coronarography is the evaluation of the coronary arteries, with the highlighting of the light coronary plaques, but also accurately measures the dimensions of the left atrium and the anatomy of the pulmonary veins. In the last years cardiac MRI (magnetic resonance imaging) has been used in the clinic and research media to establish the gold standard measurement for the volumes of heart cavities, their function and tissue structure. All these three methods are essential for the evaluation and treatment of the cardiac patient with important arrhythmia.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Eguchi K et. al., Pre-operative atrial fibrillation as the key determinant of outcome of mitral valve repair for degenerative mitral regurgitation. Eur Heart J 2005;26:1866–1872.

  • 2. Barbash I M et. al.. Predictors and clinical implications of atrial fibrillation in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation. Catheter Cardiovasc Interv 2015;85:468–477.

  • 3. Halperin J L Hart RG. Atrial fibrillation and stroke: new ideas, persisting dilemmas. Stroke 1988;19:937–941.

  • 4. Messika-Zeitoun D et. al., Left atrial remodelling in mitral regurgitation—methodologic approach, physiological determinants, and outcome implications: a prospective quantitative Doppler-echocardiographic and electron beam-computed tomographic study. Eur Heart J 2007;28:1773–1781.

  • 5. Gertz Z M et. al., Evidence of atrial functional mitral regurgitation due to atrial fibrillation: reversal with arrhythmia control. J Am Coll Cardiol 2011;58:1474–1481.

  • 6. Vahanian A et. al., ESC Committee for Practice Guidelines (CPG), Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS). Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg 2012;42:S1–44.

  • 7. Molteni M et. al., The definition of valvular and non-valvular atrial fibrillation: results of a physicians’ survey. Europace 2014;16:1720–1725.

  • 8. Walters T E, Ellims A H, Kalman J M. The role of left atrial imaging in the management of atrial fibrillation. Prog Cardiovasc Dis. 2015 Sep-Oct;58(2):136-51. doi: 10.1016/j.pcad.2015.07.010. 2015

  • 9. Alaa A. Mohamed, Ahmed A. Arifi, Ahmed Omran. The basics of echocardiography. Journal of the Saudi Heart Association (2010) 22, 71–76

  • 10. Holmes, J.H., 1980. Diagnostic ultrasound during the early years of A.I.U.M.. J. Clin. Ultrasound 8, 299–308.

  • 11. Mason, W.P., 1950. Piezoelectric Crystals and Their Application to Ultrasonics. Van Nostrand, New York.

  • 12. Edelman, S.K., 1997. Understanding Ultrasound Physics, second ed. ESP Inc., Texas, pp. 1–10.

  • 13. L. Sugeng, V. Mor-Avi, L. Weinert, et al. Quantitative assessment of left ventricular size and function: side-by-side comparison of real-time three-dimensional echocardiography and computed tomography with magnetic resonance reference Circulation, 114 (7) (2006), pp. 654-661

  • 14. A.A. Mahabadi, B. Samy, S.K. Seneviratne, et al. Quantitative assessment of left atrial volume by electrocardiographic-gated contrast-enhanced multidetector computed tomography J Cardiovasc Comput Tomogr, 3 (2) (2009), pp. 80-87

  • 15. J.M. Lacomis, W. Wigginton, C. Fuhrman, D. Schwartzman, D.R. Armfield, K.M. Peal Multi-detector row CT of the left atrium and pulmonary veins before radio-frequency catheter ablation for atrial fibrillation Radiographics, 23 (2003), pp. S35-S48

  • 16. K.M. Chinnaiyan, A.N. Bilolikar, E. Walsh, et al. CT dose reduction using prospectively triggered or fast-pitch spiral technique employed in cardiothoracic imaging (the CT dose study). J Cardiovasc Comput Tomogr, 8 (3) (2014), pp. 205-214

  • 17. N.G. Baikoussis, E. Apostolakis, N.A. Papakonstantinou, I. Sarantitis, D. Dougeni. Safety of magnetic resonance imaging in patients with implanted cardiac prostheses and metallic cardiovascular electronic devices. Ann Thorac Surg, 91 (6) (2011), pp. 2006-2011

  • 18. Peter McKavanagh, Gerard Walls, Claire McCune, Jonathon Malloy, Mark T. Harbinson, Peter A. Ball, Patrick M. Donnelly. The Essentials of Cardiac Computerized Tomography. Cardiol Ther (2015) pp:117–129

  • 19. Stary H C, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation.1995;92:1355–74.

  • 20. Guthaner DF, Wexler L, Harell G. CT demonstration of cardiac structures. Am J Roentgenol. 1979; 133:75–81.

  • 21. Agatston A S, Janowitz W R, Hildner F J, Zusmer N R, Viamonte M, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15:827–32.

  • 22. Taylor A J, Cerqueira M, Hodgson J M, et al. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI /SCAI / SCMR 2010 appropriate use criteria for cardiac computedtomography: a report of the American College of Cardiology Foundation Appropriate Use CriteriaTask Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North Cardiol Ther (2015)

  • 23. Skinner J S, Smeeth L, Kendall J M, Adams P C, Timmis A. NICE guidance. Chest pain of recent onset: assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin. Heart. 2010; 96:974–8.

  • 24. Wen-Yih Isaac Tseng, Mao-Yuan Marine Su, Yao-Hui Elton Tseng. Introduction to Cardiovascular Magnetic Resonance: Technical Principles and Clinical Applications. Acta Cardiol Sin 2016;32:129-144

  • 25. L. Santini, G.B. Forleo, M. Santini. World Society of Arrhythmias. Evaluating MRI-compatible pacemakers: patient data now paves the way to widespread clinical application? Pacing Clin Electrophysiol, 36 (3) (2013), pp. 270-278

  • 26. N.G. Baikoussis, E. Apostolakis, N.A. Papakonstantinou, I. Sarantitis, D. Dougenis.Safety of magnetic resonance imaging in patients with implanted cardiac prostheses and metallic cardiovascular electronic devices. Ann Thorac Surg, 91 (6) (2011), pp. 2006-2011

  • 27. P. Marckmann, L. Skov. Nephrogenic systemic fibrosis: clinical picture and treatment. Radiol Clin North Am, 47 (5) (2009), pp. 833-840

  • 28. Mischa T. Rijnierse, Cornelis P. Allaart, Paul Knaapen. Principles and techniques of imaging in identifying the substrate of ventricular arrhythmia. J Nucl Cardiol. 2016; 23: 218–234. Published online 2015 Dec 14. doi: 10.1007/s12350-015-0344-8

  • 29. de Bakker J, van Rijen H. Mechanisms of ventricular tachycardia: Underlying pathological and physiological abnormalities. In: Wang P, Al-Ahmad A, Hsia H, editors. Ventricular arrhythmias and sudden cardiac death. 1. Malden: Blackwell; 2008. pp. 18–27.

  • 30. Deo R, Albert CM. Epidemiology and genetics of sudden cardiac death. Circulation. 2012;125:620–637. doi: 10.1161/CIRCULATIONAHA.111.023838.

  • 31. Myerburg RJ, Junttila MJ. Sudden cardiac death caused by coronary heart disease. Circulation. 2012;125:1043–1052. doi: 10.1161/CIRCULATIONAHA.111.023846

  • 32. Stevenson WG, Weiss JN, Wiener I, Nademanee K. Slow conduction in the infarct scar: Relevance to the occurrence, detection, and ablation of ventricular reentry circuits resulting from myocardial infarction. Am Heart J. 1989;117:452–467. doi: 10.1016/0002-8703(89)90792-8

  • 33. Zaman S, Kovoor P. Sudden cardiac death early after myocardial infarction: Pathogenesis, risk stratification, and primary prevention. Circulation. 2014;129:2426–2435. doi: 10.1161/CIRCULATIONAHA.113.007497

  • 34. Zipes DP. Influence of myocardial ischemia and infarction on autonomic innervation of heart. Circulation. 1990;82:1095–1105. doi: 10.1161/01.CIR.82.4.1095

  • 35. Nikolaou K, Alkadhi H, Bamberg F, Leschka S, Wintersperger BJ. MRI and CT in the diagnosis of coronary artery disease: indications and applications. Insights Imaging. 2011; doi:10.1007/s13244-010-0049-0


Journal + Issues