- Oral presentation
- Open Access
Incremental diagnostic role of cardiac MRI in young-middle aged patients with high-grade atrio-ventricular block
© Baritussio et al. 2016
- Published: 27 January 2016
- Cardiovascular Magnetic Resonance
- Late Gadolinium Enhancement
- Significant Independent Predictor
- Short Axis Cine
- Cardiovascular Magnetic Resonance Protocol
Atrio-ventricular (AV) block is a common brady-arrhythmia in the elderly, but is a rare event in young or middle-aged adults, often leading to pacemaker implantation without further investigation, though underlying aetiology influences both treatment strategies and prognosis. Cardiovascular magnetic resonance (CMR) has the potential to identify an underlying aetiology for AV block, over and above transthoracic echocardiogram (TTE), which is offered as the first imaging technique. We sought to assess the diagnostic additive role of CMR in young and middle aged adults (18-60 years) with high-grade AV block and to determine which findings on CMR best predict clinical impact.
We retrospectively analysed the CMR registry from a tertiary centre in the South-West of England to collect data on consecutive high-grade AV block patients (18-60 yrs) referred for CMR between September 2012 to July 2015. High-grade AVB was defined as the evidence of Mobitz II 2nd degree or complete AVB on resting electrocardiogram (ECG). Patients underwent TTE and a comprehensive CMR protocol (including long and short axis cines, and late gadolinium enhancement, LGE, imaging). A change in diagnosis was defined as CMR findings leading to a new diagnosis compared to a multi-parametric pre-CMR diagnosis (clinical data, ECG and TTE).
Predictors of clinical impact
95% C.I. for EXP (B)
Management of AVB in young is challenging. Our study highlights that CMR can lead to a new diagnosis in almost half of patients. LGE was the only significant independent predictor of a new diagnosis compared to other imaging characteristics like biventricular ejection fraction and volumes. CMR should be included in the diagnostic work up of young patients with high grade AVB.
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