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Diffuse myocardial fibrosis associates with incident ventricular arrhythmia in implantable cardioverter defibrillator recipients.

Eric OlaussonJonathon WertzYaron FridmanPatrick BeringMaren MaanjaLouise NiklassonTimothy C WongMiho FukuiJo O L CavalcanteGeorge CaterPeter KellmanSyed BukhariChristopher A MillerSamir SabaMartin UganderErik B Schelbert
Published in: medRxiv : the preprint server for health sciences (2023)
Analogous to heart failure and mortality outcomes, diffuse myocardial fibrosis (DMF) quantified by extracellular volume (ECV) may represent a more vulnerable phenotype for life-threatening ventricular arrhythmia than focal myocardial fibrosis. In patients referred for cardiovascular magnetic resonance, we identified 215 subsequently receiving implantable cardioverter defibrillators (ICD). After a median of 2.9 (IQR 1.5-4.2) years, 25 patients experienced ICD shock and 44 experienced shock or anti-tachycardia pacing. ECV associated with ICD therapy in Cox regression models. Focal fibrosis variables or global longitudinal strain did not. ECV-based risk stratification and DMF representing a therapeutic target to prevent ventricular arrhythmia warrant further investigation.
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