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Neuronal Imaging, Ventricular Arrhythmias, and Device Therapy in Heart Failure

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Abstract

Since the 1970s, cardiovascular mortality has decreased significantly as the result of identification and modification of cardiac risk factors, improvement in cardiovascular treatments, and advances in diagnostic imaging. One major advance was the introduction of the implantable cardiac defibrillator (ICD), which substantially increased survival in patients with cardiomyopathy. Unfortunately, however, accurate identification of patients who will develop sudden cardiac death (SCD) remains elusive. Many patients who meet criteria for ICD implantation never require device-administered therapy for ventricular tachyarrhythmias. Conversely, most patients who die suddenly do not meet current guideline criteria for ICD placement before their event. Therefore, a noninvasive test that can identify at-risk patients prospectively would be ideal. Data are mounting showing that radionuclide imaging with iodine-123 metaiodobenzylguanidine (123I-MIBG) for single-photon emission computed tomography (SPECT) or carbon-11 hydroxyephedrine (11C-HED) for positron emission tomography (PET) may provide important prognostic information regarding the development of SCD and might be used to risk stratify patients.

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  1. University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA

    David M. Harris MD, PhD & Myron C. Gerson MD, PhD

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  1. Division of Nuclear Medicine Department of Diagnostic Radiology, University of Maryland School of Medicine, Baltimore, Maryland, USA

    Vasken Dilsizian

  2. Division of Cardiology, Mount Sinai Medical Center, New York, New York, USA

    Jagat Narula

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Harris, D.M., Gerson, M.C. (2017). Neuronal Imaging, Ventricular Arrhythmias, and Device Therapy in Heart Failure. In: Dilsizian, V., Narula, J. (eds) Atlas of Cardiac Innervation. Springer, Cham. https://doi.org/10.1007/978-3-319-45800-7_7

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  • DOI: https://doi.org/10.1007/978-3-319-45800-7_7

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