Amano Yasuo, Iso Kazuki, Suzuki Yasuyuki, Tachi Masaki
Department of Radiology, Nihon University Hospital, Tokyo 1018309, Japan.
Department of Cardiology, Nihon University Hospital, Tokyo 1018309, Japan.
World J Radiol. 2025 Jul 28;17(7):107140. doi: 10.4329/wjr.v17.i7.107140.
Sudden cardiac death (SCD) is one of the most devastating sequelae of myocardial diseases and can be the initial symptom in younger athletes or middle-aged businesspeople. An implantable cardioverter defibrillator (ICD) prevents SCD and dramatically reduces the arrhythmic events in these patients; hence, the risk stratification for the SCD is important. In survivors of out-of-hospital cardiac arrest, identification of its etiologies is required to select the appropriate treatments following ICD installation. Cardiac magnetic resonance imaging (MRI) is useful for evaluating the morphology and function of the heart and for tissue characterization, MRI can therefore be used to stratify the risk of SCD associated with various myocardial diseases and leads to primary prevention using ICD. MRI can predict arrhythmic events, which suggest the progression of myocardial damage, following secondary prevention. In this review, we provide a clinical and MRI focused update and MRI protocol for the primary and secondary prevention of SCD. We summarize the contribution and limitations of cardiac MRI for prevention SCD using ICD implantation.
心脏性猝死（SCD）是心肌疾病最具破坏性的后遗症之一，可能是年轻运动员或中年商务人士的首发症状。植入式心脏复律除颤器（ICD）可预防SCD，并显著减少这些患者的心律失常事件；因此，SCD的风险分层很重要。在院外心脏骤停幸存者中，需要确定其病因，以便在安装ICD后选择合适的治疗方法。心脏磁共振成像（MRI）有助于评估心脏的形态和功能以及进行组织特征分析，因此MRI可用于对与各种心肌疾病相关的SCD风险进行分层，并指导使用ICD进行一级预防。MRI可预测二级预防后提示心肌损伤进展的心律失常事件。在本综述中，我们提供了以临床和MRI为重点的SCD一级和二级预防的最新进展及MRI方案。我们总结了心脏MRI在使用ICD植入预防SCD方面的作用和局限性。
