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. 2021 Oct 5;11(10):1840. doi: 10.3390/diagnostics11101840

Table 2.

Indications, merits, and limitations of imaging tests in patients with premature ventricular contractions. 3D, three-dimensional; CAD, coronary artery disease; CIEDs, cardiac implantable electronic devices; EF, ejection fraction; EMB, endomyocardial biopsy; LV, left ventricular; PCI, percutaneous coronary intervention; PVCs, premature ventricular contractions; RV, right ventricle; RVOT, right ventricular outflow tract; SCD, sudden cardiac death; VT, ventricular tachycardia.

Imaging Test Indications Advantages Limitations
Echocardiogram Potentially indicated in each patient presenting PVCs; may be omitted in asymptomatic healthy subjects with low PVC burden and no family history of SCD
  • -

    Widely available

  • -

    Lack of contrast/radiation exposure

  • -

    May be repeated over time

  • -

    Allows precise measurement of LV EF
  • -

    Operator-dependent

  • -

    Does not allow myocardial tissue characterization

  • -

    Suboptimal visualization of complex 3D structures, including the RV
Cardiac magnetic resonance imaging
  • -

    PVCs arising from unusual locations

  • -

    Sustained VT

  • -

    Suspected structural heart disease by echocardiogram

  • -

    Reduced LV EF
  • -

    Unlimited number of imaging planes

  • -

    Accurate tissue characterization

  • -

    Gold-standard assessment of ventricular structure and function (i.e., LV EF)
  • -

    Gating difficulties/artifacts due to PVCs

  • -

    False positive detection of intramyocardial fat

  • -

    Difficult detection of RV fibrosis

  • -

    Patients with CIEDs

  • -

    Gadolinium exposure
Computed tomographic coronary angiography
  • -

    Reduced LV EF

  • -

    Symptoms indicating a possible underlying CAD

  • -

    low-to-intermediate pre-test probability of CAD
  • -

    Non-invasive assessment of coronary anatomy

  • -

    Limited radiation exposure

  • -

    Possible identification of myocardial fibrosis
  • -

    Contrast and radiation exposure
Invasive coronary angiography
  • -

    Reduced LV EF

  • -

    Symptoms indicating a possible underlying CAD

  • -

    intermediate-to-high pre-test probability of CAD
  • -

    Gold-standard assessment of coronary anatomy

  • -

    PCI in the same session
  • -

    Invasive test

  • -

    Contrast and radiation exposure
Electroanatomical mapping
  • -

    Preliminary test for catheter ablation or EMB

  • -

    Suspected arrhythmogenic cardiomyopathy
  • -

    Accurate assessment of the myocardial substrate

  • -

    Enhances diagnostic yield of EMB
  • -

    Invasive test

  • -

    Operator and tissue contact-dependent