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ORIGINAL RESEARCH article

Front. Radiol.
Sec. Cardiothoracic Imaging
Volume 4 - 2024 | doi: 10.3389/fradi.2024.1327406

Wideband Radiofrequency Pulse Sequence for Evaluation of Myocardial Scar in patients with Cardiac Implantable Devices

Provisionally accepted
Neil Shah Neil Shah 1Mayil Krishnam Mayil Krishnam 2Bharath Ambale Venkatesh Bharath Ambale Venkatesh 3Fouzia Khan Fouzia Khan 4Michele Smith Michele Smith 2Darwin R. Jones Darwin R. Jones 2Patrick Koon Patrick Koon 5Xianglun Mao Xianglun Mao 5Martin A. Janich Martin A. Janich 6Anja C. Brau Anja C. Brau 5Michael Salerno Michael Salerno 2Rajesh Dash Rajesh Dash 2Frandics Chan Frandics Chan 2Phillip C. Yang Phillip C. Yang 2*
  • 1 Medical College of Wisconsin, Milwaukee, United States
  • 2 Stanford Healthcare, Stanford, California, United States
  • 3 Johns Hopkins Medicine, Johns Hopkins University, Baltimore, Maryland, United States
  • 4 Stanford University, Stanford, California, United States
  • 5 GE Healthcare (United States), Marlborough, Massachusetts, United States
  • 6 GE Healthcare (Germany), Munich, Bavaria, Germany

The final, formatted version of the article will be published soon.

    Background: Cardiac magnetic resonance is a useful clinical tool to identify late gadolinium enhancement in heart failure patients with implantable electronic devices. Identification of LGE in patients with CIED is limited by artifact, which can be improved with a wide band radiofrequency pulse sequence.Objective: The authors hypothesize that image quality of LGE images produced using wide-band pulse sequence in patients with devices is comparable to image quality produced using standardLGE sequences in patients without devices. Methods: Two independent readers reviewed LGE images of 16 patients with CIED and 7 patients without intracardiac devices to assess for image quality, device-related artifact, and presence of LGE using the American Society of Echocardiography/American Heart Association 17 segment model of the heart on a 4-point Likert scale. The mean and standard deviation for image quality and artifact rating were determined. Inter-observer reliability was determined by calculating Cohen's kappa coefficient. Statistical significance was determined by T-test as a p {less than or equal to} 0.05 with a 95% confidence interval.Results: All patients underwent CMR without any adverse events. Overall IQ of WB LGE images was significantly better in patients with devices compared to standard LGE in patients without devices (p = 0.001) with reduction in overall artifact rating (p=0.05) .Our study suggests wide-band pulse sequence for LGE can be applied safely to heart failure patients with devices in detection of LV myocardial scar while maintaining image quality, reducing artifact, and following routine imaging protocol after intravenous gadolinium contrast administration.

    Keywords: wide band pulse, Late gadolinium enhancement (LGE), Cardiac MRI (CMR), intracardiac device, Image Quality (IQ)

    Received: 24 Oct 2023; Accepted: 17 Jul 2024.

    Copyright: © 2024 Shah, Krishnam, Ambale Venkatesh, Khan, Smith, Jones, Koon, Mao, Janich, Brau, Salerno, Dash, Chan and Yang. 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: Phillip C. Yang, Stanford Healthcare, Stanford, 94305, California, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.