Abstract
Introduction: Premature ventricular contractions (PVCs) and/or ventricular tachycardia (VT) are common arrhythmias encountered in clinical practice. However, a significant proportion of patients have no identifiable underlying cause after undergoing routine diagnostic evaluations. Cardiac magnetic resonance imaging (CMR) has the capability to detect structural and functional abnormalities of the heart that may be missed by other modalities, potentially leading to changes in diagnosis and treatment strategies. Subjects and Methods: A descriptive study was conducted on 24 patients diagnosed with PVCs with a burden >10% and/or sustained VT, with no evidence of structural heart disease based on routine evaluations, including echocardiography. All patients underwent CMR. Findings from CMR were used to update diagnoses and modify treatment strategies in some of the studied patients. Results: The mean age was 36.8 ± 16.3 years, and 62.5% were male. All patients (100%) presented with palpitations. 16 patients (66.7%) had both PVCs and VT episodes. The mean PVC burden was 18.3 ± 10.3%. CMR detected abnormalities in 9 out of 24 patients (37.5%). These abnormalities included: • Arrhythmogenic right ventricular cardiomyopathy (ARVC) in 2 patients • Left ventricular non-compaction (LVNC) in 1 patient • Right ventricular apical aneurysm in 1 patient • Late gadolinium enhancement (LGE) suggestive of previous myocarditis in 2 patients • Right heart chamber dilation in 2 patients • Biventricular systolic dysfunction in 1 patient Older age and the presence of chest pain were statistically significantly associated with the detection of abnormalities on CMR (p < 0.05). The CMR findings led to changes in diagnosis and treatment strategies in all 9 of these patients, including the implantation of implantable cardioverter-defibrillators (ICD), radiofrequency catheter ablation (RFCA), and adjustment of medical treatment regimens.
