Maryland Arrhythmia and Cardiology Imaging Group (MACIG), Department of Medicine, Division of Cardiology, University of Maryland Medical Center, 22 South Greene St, Baltimore, MD, 21201, USA.
Curr Cardiol Rep. 2013 May;15(5):359. doi: 10.1007/s11886-013-0359-1.
Implantable cardioverter-defibrillators (ICDs) significantly reduce mortality in patients with depressed left ventricular ejection fraction (LVEF) and heart failure (HF). However, shortcomings of LVEF to accurately identify those at greatest risk of ventricular tachyarrhythmias have led to the pursuit of alternative means to refine qualification criteria for ICD implantation. It is well established that imaging the cardiac nervous system with(123)I meta-iodobenzylguanidine ((123)I-mIBG) provides incremental prognostic value in patients with HF beyond LVEF. Whether (123)I-mIBG will also play an important role for identifying and/or predicting sustained ventricular tachyarrhythmias in patients with cardiomyopathy and determining those who may benefit from ICD implantation is currently under investigation. Novel imaging approaches that pinpoint the site of ventricular arrhythmias and guide ventricular tachycardia ablation are presented.
植入式心脏复律除颤器 (ICD) 可显著降低左心室射血分数 (LVEF) 和心力衰竭 (HF) 降低的患者的死亡率。然而，LVEF 无法准确识别发生室性心动过速风险最高的患者，这促使人们寻求替代方法来完善 ICD 植入的资格标准。已经证实，用(123)I 间碘苄胍 ((123)I-mIBG) 对心脏神经系统进行成像，可在 HF 患者中提供比 LVEF 更有价值的预后信息。(123)I-mIBG 是否也将在确定和/或预测心肌病患者的持续性室性心动过速以及确定哪些患者可能受益于 ICD 植入方面发挥重要作用，目前正在研究中。本文介绍了精确定位室性心律失常部位并指导室性心动过速消融的新型成像方法。
