Impact of CMR on ICD Eligibility
Author Information
Author(s): Joshi Subodh B, Connelly Kim A, Hansen Mark, McSweeney Sean, Liu Jerome, Yang Yuesong, Jimenez-Juan Laura, Al-Hesayen Abdul, Mangat Iqwal, Dorian Paul, Wright Graham A, Crean Andrew, Kirpalani Anish, Yan Andrew T, Leong-Poi Howard
Primary Institution: St Michael's Hospital, Toronto, ON, Canada
Hypothesis
Does cardiovascular magnetic resonance (CMR) assessment of left ventricular ejection fraction (LVEF) change eligibility for implantable cardioverter defibrillators (ICDs) compared to echocardiography?
Conclusion
CMR assessment of LVEF changed ICD eligibility for a significant number of patients compared to echocardiography.
Supporting Evidence
- CMR and echocardiography derived LVEFs were reported by two independent blinded observers.
- The mean LVEF by CMR was 31% and by echo was 34%.
- CMR changed ICD eligibility in 20% of patients using an LVEF threshold of 35%.
- CMR changed ICD eligibility in 16% of patients using an LVEF threshold of 30%.
- The correlation coefficient between CMR and echo LVEF was 0.86.
Takeaway
Doctors used a special heart scan to check if patients could get a heart device, and it showed different results than the usual heart ultrasound.
Methodology
Patients referred for LVEF measurement by CMR also underwent echocardiography within 30 days, with LVEF assessed by both methods.
Potential Biases
Potential bias from the independent observers who reported LVEF results.
Limitations
The study only included patients who were referred for LVEF measurement and may not represent all patients.
Participant Demographics
49 patients (10 female, mean age 61 years, 24 with ischemic etiology).
Statistical Information
P-Value
0.009
Statistical Significance
p=0.009
Digital Object Identifier (DOI)
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