MPI can elucidate remodeling in patients who are postcardiac resynchronization therapy, with differential incidence of ventricular arrhythmia [84], and gated SPECT imaging phase analysis has shown potential in differentiating degrees of mechanical dyssynchrony [85]. Dyspnea-Suspected Cardiac Origin US Echocardiography Transesophageal There is scant literature regarding the use of TEE in the assessment of suspected arrhythmia. Left atrial appendage size (left atrial appendage end-diastolic volume [P = . 002; OR 1.6] and morphology [cauliflower shape (P = . 001; OR, 10.2)]) are predictive of thromboembolic events in patients with nonvalvular atrial fibrillation [86]. US Echocardiography Transthoracic Resting Echocardiography is an important noninvasive imaging technique in the diagnosis and prognosis of patients with arrhythmias, providing insight into associated myocardial, valvular, and structural disorders. Morphologic and functional criteria are useful in RV assessment in cases of suspected ARVC/D [83]. Assessment of LV function by speckle-tracking strain assessment has shown utility in prediction of ventricular arrhythmia in patients post-LV assist devices placement [87], and ejection fraction as assessed by echocardiography has shown predictive value in ventricular arrhythmia as well as in all-cause mortality in heart failure patients with implantable cardioverter- defibrillators [88]. Although epicardial fat is rarely noted on clinical reports, associations have been noted between epicardial fat thickness as measured on echocardiography and dysrhythmia [94], in the prediction of successful electrical cardioversion and atrial fibrillation recurrence [95,96], and in the ablation of premature ventricular contractions [97]. Measurement of left atrial volume has shown to be a predictor of persistent atrial fibrillation after mitral valve surgery, with indexed volume >39 mL/m2 having a sensitivity of 79% (AUC: 0.762, SE: 0.051, P < . 001) [98].
Dyspnea Suspected Cardiac Origin Ischemia Already Excluded . MPI can elucidate remodeling in patients who are postcardiac resynchronization therapy, with differential incidence of ventricular arrhythmia [84], and gated SPECT imaging phase analysis has shown potential in differentiating degrees of mechanical dyssynchrony [85]. Dyspnea-Suspected Cardiac Origin US Echocardiography Transesophageal There is scant literature regarding the use of TEE in the assessment of suspected arrhythmia. Left atrial appendage size (left atrial appendage end-diastolic volume [P = . 002; OR 1.6] and morphology [cauliflower shape (P = . 001; OR, 10.2)]) are predictive of thromboembolic events in patients with nonvalvular atrial fibrillation [86]. US Echocardiography Transthoracic Resting Echocardiography is an important noninvasive imaging technique in the diagnosis and prognosis of patients with arrhythmias, providing insight into associated myocardial, valvular, and structural disorders. Morphologic and functional criteria are useful in RV assessment in cases of suspected ARVC/D [83]. Assessment of LV function by speckle-tracking strain assessment has shown utility in prediction of ventricular arrhythmia in patients post-LV assist devices placement [87], and ejection fraction as assessed by echocardiography has shown predictive value in ventricular arrhythmia as well as in all-cause mortality in heart failure patients with implantable cardioverter- defibrillators [88]. Although epicardial fat is rarely noted on clinical reports, associations have been noted between epicardial fat thickness as measured on echocardiography and dysrhythmia [94], in the prediction of successful electrical cardioversion and atrial fibrillation recurrence [95,96], and in the ablation of premature ventricular contractions [97]. Measurement of left atrial volume has shown to be a predictor of persistent atrial fibrillation after mitral valve surgery, with indexed volume >39 mL/m2 having a sensitivity of 79% (AUC: 0.762, SE: 0.051, P < . 001) [98].