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Using imaging techniques to predict arrhythmia

Dr. K. Hermann Haugaa, Depart- ment Of Cardiology, Rikshospitalet, Oslo University Hospital, Norway



“My focus here is on the prediction of arrhythmias using imaging in a dis- ease called arrhythmogenic right ventricular cardiomyopathy (ARVC). It is a genetic disease that may or may not be apparent to patients, as some of them go through life without anything happening, while others die suddenly.

It is the most common cause of sud- den death in athletes in Europe, typi- cally footballers. So when you see on television that a footballer has died suddenly, or that they have a cardiac arrest, it’s often this disease. All our efforts are therefore geared towards preventing these collapses and sud- den cardiac events.

What we know is that the amount of sport and exercise you have done during your lifetime plays a role. If you have done more exercise, you are more prone to sudden death, which is the opposite of what you would think. Normally, more exercise is considered good for your heart and your life expectancy, but in this case it’s the other way around. So those patients who exercise the most have the highest risk of dying suddenly, which is why it has a higher frequency among sportspeople and top athletes.

So what can we do with imaging techniques? Thanks to genetic testing, we now know which family members of cases who have the genetic mutation and are at higher risk, and they can now be followed clinically. Because we now know about them, we have the responsibility to prevent sudden death, of course. Therefore we use imaging among other diagnostic criteria, with echocardiography and cardiovascular magnetic resonance imaging, to make the diagnosis and follow them up.

The latest development with echocardiography is that we can use it to look for early signs, and we have some candidate parameters that we think may be good early indicators of the risk of sudden death.”