PMID- 30739658 OWN - NLM STAT- MEDLINE DCOM- 20200108 LR - 20210630 IS - 1879-1913 (Electronic) IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 123 IP - 8 DP - 2019 Apr 15 TI - Feasibility of Cardiac Magnetic Resonance Wideband Protocol in Patients With Implantable Cardioverter Defibrillators and Its Utility for Defining Scar. PG - 1329-1335 LID - S0002-9149(19)30110-9 [pii] LID - 10.1016/j.amjcard.2019.01.018 [doi] AB - Implantable cardioverter defibrillators (ICDs) have been a relative contraindication to cardiovascular magnetic resonance imaging. Although cardiovascular magnetic resonance provides valuable information regarding scar in patients with ventricular arrhythmias or cardiomyopathy, ICDs in these patients frequently cause artifacts hindering accurate interpretation of both cine and late gadolinium enhancement (LGE) images. We sought to quantify the frequency and severity of artifact on LGE images and assess whether a modified wideband LGE protocol could improve the diagnostic yield of scar identification in agreement with invasive electroanatomic mapping (EAM). Forty-nine patients with ICDs and ventricular tachycardia (VT) or cardiomyopathy underwent CMR (Philips 1.5T), including standard and wideband LGE imaging. A safety algorithm was followed throughout the protocol. Standard and wideband LGE short-axis images were graded using an artifact score on a per-slice basis. LGE on wideband images was compared with EAM in 27 of 49 patients who underwent VT ablation. There were no adverse patient- or device-related events. With standard LGE imaging, 84% of patients demonstrated some degree of hyperenhancement artifact, which persisted in 22% on wideband LGE but with much less extent. Wideband LGE imaging resulted in an increase from 48% to 94% diagnostic-quality slices, with a significant reduction in artifact score, and correlated with EAM in 21 of 27 patients (78%). In conclusion, assessment of standard LGE is markedly limited by artifact in patients with ICD. The use of wideband LGE significantly improves image quality and can accurately localize myocardial scar before VT ablation. CI - Copyright (c) 2019 Elsevier Inc. All rights reserved. FAU - Singh, Amita AU - Singh A AD - University of Chicago Medical Center, Chicago, Illinois. FAU - Kawaji, Keigo AU - Kawaji K AD - University of Chicago Medical Center, Chicago, Illinois. FAU - Goyal, Neha AU - Goyal N AD - University of Chicago Medical Center, Chicago, Illinois. FAU - Nazir, Noreen T AU - Nazir NT AD - University of Chicago Medical Center, Chicago, Illinois. FAU - Beaser, Andrew AU - Beaser A AD - University of Chicago Medical Center, Chicago, Illinois. FAU - O'Keefe-Baker, Virginia AU - O'Keefe-Baker V AD - University of Chicago Medical Center, Chicago, Illinois. FAU - Addetia, Karima AU - Addetia K AD - University of Chicago Medical Center, Chicago, Illinois. FAU - Tung, Roderick AU - Tung R AD - University of Chicago Medical Center, Chicago, Illinois. FAU - Hu, Peng AU - Hu P AD - University of California, Los Angeles, California. FAU - Mor-Avi, Victor AU - Mor-Avi V AD - University of Chicago Medical Center, Chicago, Illinois. FAU - Patel, Amit R AU - Patel AR AD - University of Chicago Medical Center, Chicago, Illinois. Electronic address: apatel2@medicine.bsd.uchicago.edu. LA - eng GR - T32 HL007381/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20190131 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Cicatrix/*diagnosis/etiology MH - Defibrillators, Implantable/*adverse effects MH - Feasibility Studies MH - Female MH - Follow-Up Studies MH - Humans MH - Image Enhancement MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - Middle Aged MH - Myocardium/*pathology MH - Prospective Studies MH - Reproducibility of Results MH - Tachycardia, Ventricular/diagnosis/physiopathology/*therapy PMC - PMC8240651 MID - NIHMS1711969 EDAT- 2019/02/12 06:00 MHDA- 2020/01/09 06:00 PMCR- 2021/06/29 CRDT- 2019/02/12 06:00 PHST- 2018/11/19 00:00 [received] PHST- 2019/01/10 00:00 [revised] PHST- 2019/01/11 00:00 [accepted] PHST- 2019/02/12 06:00 [pubmed] PHST- 2020/01/09 06:00 [medline] PHST- 2019/02/12 06:00 [entrez] PHST- 2021/06/29 00:00 [pmc-release] AID - S0002-9149(19)30110-9 [pii] AID - 10.1016/j.amjcard.2019.01.018 [doi] PST - ppublish SO - Am J Cardiol. 2019 Apr 15;123(8):1329-1335. doi: 10.1016/j.amjcard.2019.01.018. Epub 2019 Jan 31.