Abstract 18917: Multimodality Imaging in ICD Implantation Decision Making in Heart Failure Patients: Role of 123-Iodine Metaiodobenzylguanidine Imaging and Cardiac Magnetic Resonance Imaging

Introduction: According to guidelines, implantable cardioverter defibrillator (ICD) is recommended in prevention of sudden cardiac death (SCD) in heart failure (HF) patients (pts). Guidelines have several limitations because ICD indication is based mainly on left ventricular ejection fraction (EF). Recently, 123-iodine metaiodobenzylguanidine imaging (123-I MIBG) seems to identify, independently from EF, pts at high risk of SCD (heart/mediastinum (H/M) ratio < 1.6 and a summed score (SS)> 26). Hypothesis: Our aim is to assess the role of 123-I MIBG combined with cardiac MRI to predict malignant ventricular tachyarrhythmia in HF pts. Methods: we enrolled 69 pts, consecutively admitted to our hospital with diagnosis of HF and EF<35%, NYHA class II and III, who underwent 123-I MIBG imaging and cardiac MRI. Summed score (SS) of 26 was used as cut-off to identify high risk (group 1) versus low risk (group 2) pts. Late gadolinium enhancement (LGE) and number of segments with scars were evaluated in the 2 ...