CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1596440
This article is part of the Research TopicCardiovascular Imaging Case Reports 2025: Emphasizing Uncommon Clinical ScenariosView all 3 articles
Hemodynamic Consequences of Severe Supraventricular Arrhythmia assessed by Real-time Magnetic Resonance Imaging in Combination with Electrocardiography
Provisionally accepted
Lena Maria Röwer1
Miriam Nathalie Tappel1Mohamed Ali Goundi1Anja Müller-Lutz1Mohamed Abd El Rahman2Jana Rieke2Gerrit Steinhagen3Emmel Mathias4Dirk Klee1
Frank Pillekamp1*- 1Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
- 2Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
- 3Practice for Pediatric Cardiology, Pediatric Pulmonology, Allergology and Pediatrics, Hilden, Germany
- 4Department of Pediatric Cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
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A 13-year-old asymptomatic boy presented with new-onset of extrasystoles. The initial electrocardiogram (ECG) showed an irregular heart rhythm with some sinus beats but also numerous premature atrial contractions with aberrant ventricular conduction. While the initial cardiovascular magnetic resonance (CMR) study still could be performed conventionally, more irregular extrasystoles impeded the follow-up study. Therefore, cardiac real-time MRI (RT-MRI) was performed in combination with simultaneously acquired ECG that enabled high image quality and the analysis of sinus and arrhythmic beats separately. RT-MRI volumetry of a sinus beat showed a stable systolic function for the left ventricle (LV): LV ejection fraction 54.3 %, LV stroke volume 61.1 ml/m² (90 th percentile)) and increased but stable LV volumes: (LV end-diastolic volume 112.6 ml/m² (>97 th percentile), LV end-systolic volume 51.1 ml/m² (>97 th percentile)). In contrast, right ventricular (RV) function was reduced in sinus beats. In premature contractions, RV and LV end-diastolic volume, stroke volume and ejection fraction were lower, end-systolic volume was higher. In this patient with severe cardiac arrhythmias, conventional CMR could not provide adequate image quality. RT-MRI offered high image quality during free breathing and, in combination with ECG, the unique opportunity to analyze the hemodynamics of premature beats and sinus beats as separate entities.
Keywords: cardiac arrhythmias, Atrial Premature Complexes, cardiovascular magnetic resonance imaging, Real-time MRI, Pediatrics
Received: 19 Mar 2025; Accepted: 26 May 2025.
Copyright: © 2025 Röwer, Tappel, Goundi, Müller-Lutz, Abd El Rahman, Rieke, Steinhagen, Mathias, Klee and Pillekamp. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Frank Pillekamp, Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
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