title: Principles and techniques of imaging in identifying the substrate of ventricular arrhythmia.
abstract: Life-threatening ventricular arrhythmias (VA) are a major cause of death in patients with cardiomyopathy. To date, impaired left ventricular ejection fraction remains the primary criterion for implantable cardioverter-defibrillator therapy to prevent sudden cardiac death. In recent years, however, advanced imaging techniques such as nuclear imaging, cardiac magnetic resonance imaging, and computed tomography have allowed for a more detailed evaluation of the underlying substrate of VA. These imaging modalities have emerged as a promising approach to assess the risk of sudden cardiac death. In addition, non-invasive identification of the critical sites of arrhythmias may guide ablation therapy. Typical anatomical substrates that can be evaluated by multiple advanced imaging techniques include perfusion abnormalities, scar and its border zone, and sympathetic denervation. Understanding the principles and techniques of different imaging modalities is essential to gain more insight in their role in identifying the arrhythmic substrate. The current review describes the principles of currently available imaging techniques to identify the substrate of VA.
authors.affiliation: Department of Cardiology and Institute for Cardiovascular Research (IcaR-VU), VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Mischa T
authors.initials: MT
authors.lastname: Rijnierse
authors.affiliation: Department of Cardiology and Institute for Cardiovascular Research (IcaR-VU), VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Cornelis P
authors.initials: CP
authors.lastname: Allaart
authors.affiliation: Department of Cardiology and Institute for Cardiovascular Research (IcaR-VU), VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. p.knaapen@vumc.nl.
authors.forename: Paul
authors.initials: P
authors.lastname: Knaapen
mesh_terms: D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging*; D019788:Fluorodeoxyglucose F18; D006321:Heart / Q000294:innervation; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D055414:Myocardial Perfusion Imaging; D009206:Myocardium / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: PET imaging; SPECT; computed tomography (CT); magnetic resonance imaging; ventricular tachycardia