Use of cardiac radionuclide imaging to identify patients at risk for arrhythmic sudden cardiac death

Iosif Kelesidis, Mark I. Travin

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Sudden cardiac death (SCD) accounts for about 1/2 of all cardiovascular deaths, in most cases the result of a lethal ventricular arrhythmia. Patients considered at risk are often treated with an implantable cardiac defibrillator (ICD), but current criteria for device use, based largely on left ventricular ejection fraction (LVEF), leads to many patients receiving ICDs that they do not use, and many others not receiving ICDs but who suffer SCD. Thus, better methods of identifying patients at risk for SCD are needed, and radionuclide imaging offers much potential. Recent work has focused on imaging of cardiac autonomic innervation. 123I-mIBG, a norepinephrine analog, is the tracer most studied, and a variety of positron emission tomographic tracers are also under investigation. Radionuclide autonomic imaging may identify at-risk patients with ischemic coronary artery disease, particularly following myocardial infarction and in the setting of hibernating myocardium. Most studies have been done in the setting of congestive heart failure (CHF), with a recent large multicenter study of patients with advanced disease, typically at high risk of SCD, showing that 123I-mIBG can identify a low risk subgroup with an extremely low incidence of lethal ventricular arrhythmias and cardiac death, therefore, perhaps not requiring an ICD. Cardiac neuronal imaging has been shown to be better predictive of lethal arrhythmias/cardiac death than LVEF and New York Heart Association class, as well as various ECG parameters. Autonomic imaging will likely play an important role in the advancement of cardiac molecular imaging.

Original languageEnglish (US)
Pages (from-to)142-152
Number of pages11
JournalJournal of Nuclear Cardiology
Volume19
Issue number1
DOIs
StatePublished - Feb 2012

Fingerprint

Sudden Cardiac Death
Radionuclide Imaging
Cardiac Arrhythmias
Implantable Defibrillators
Stroke Volume
Molecular Imaging
Multicenter Studies
Coronary Artery Disease
Myocardium
Norepinephrine
Electrocardiography
Heart Failure
Myocardial Infarction
Electrons
Equipment and Supplies
Incidence

Keywords

  • I-mIBG
  • Cardiac autonomic imaging
  • Sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Use of cardiac radionuclide imaging to identify patients at risk for arrhythmic sudden cardiac death. / Kelesidis, Iosif; Travin, Mark I.

In: Journal of Nuclear Cardiology, Vol. 19, No. 1, 02.2012, p. 142-152.

Research output: Contribution to journalArticle

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