42 year old man with history of idiopathic VF arrest in July 2016 s/p ICD placement, referred for cardiac MRI to evaluate scar burden. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 59%, the LV end diastolic volume index is 99 ml/m2 (normal range: 74+/-15), the LVEDV is 201 ml (normal range 142+/-34), the LV end systolic volume index is 40 ml/m2 (normal range 25+/-9), the LVESV is 83 ml (normal range 47+/-19). There are no gross regional wall motion abnormalities present. With standard late gadolinium imaging there was significant artifact associated with the ICD, overlying the basal to mid segments of the anterior wall. This was improved with wideband imaging with a frequency shift of +1500Hz, which demonstrated no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is grossly normal in size. Right VentricleThe right ventricle is grossly An ICD lead terminates in the apex of the right ventricle.Right AtriumThe right atrium is grossly normal in size. There is a transvenous lead traversing the right atrium.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve is not well seen.Tricuspid ValveThe tricuspid valve opens widely. There is no obvious tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. Pulmonary VeinsThere are four pulmonary veins which drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is not well visualized.Venous AnatomyThe SVC and IVC drain normally into the right atrium. Transvenous leads are seen in the SVC.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThis study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered.
1. The left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 59%.2. With standard late gadolinium imaging there was significant artifact associated with the ICD, overlying the basal to mid segments of the anterior wall. This was improved with wideband imaging with a frequency shift of +1500Hz, which demonstrated no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. The right ventricle appears visually normal in size with normal systolic function.4. A single lead ICD is present.