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Autonomic Imaging in Ventricular Arrhythmias

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Autonomic Innervation of the Heart

Abstract

Ventricular arrhythmias may occur in cardiomyopathies, with often fatal consequences. Arrhythmias can occur during physical activity with sympathetic activation, for example, in the case of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D), or at rest with parasympathetic activation, for example, in patients with Brugada syndrome. Medication with effect on the autonomous nervous system, most notably β-receptor blockers, can modulate the disease manifestations associated with arrhythmias such as syncopes. There is a strong clinical need to identify the optimal treatment strategy in a personalized manner. Molecular imaging of the autonomous nervous system may add valuable additional information. Radiopharmaceuticals targeting the presynaptic and postsynaptic portions of the sympathetic system for use with single-photon emission computed tomography (SPECT) and positron-emission tomography (PET) have seen the most widespread application; studies also targeting the parasympathetic function have started to appear. This chapter provides an overview over results obtained with these molecular imaging modalities so far.

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Abbreviations

ARVC/D:

Arrhythmogenic right ventricular cardiomyopathy/dysplasia

ARVD/C:

Arrhythmogenic right ventricular dysplasia/cardiomyopathy

BS:

Brugada syndrome

DCM:

Dilated cardiomyopathy

ECG:

Electrocardiogram

EP:

Electrophysiological

HCM:

Hypertrophic cardiomyopathy

HMR:

Heart-to-mediastinum ratio

ICD:

Implantable cardioverter–defibrillator

ILVT:

Idiopathic left ventricular tachycardia

IVF:

Idiopathic ventricular fibrillation

IVT:

Idiopathic ventricular tachycardias

LQTS:

Long QT syndrome

LV:

Left ventricle

LVEF:

Left ventricular ejection fraction

MQNB:

Methylquinuclidinylbenzilat

PET:

Positron-emission tomography

RVOT:

Right ventricular outflow tract tachycardia

SPECT:

Single-photon emission computed tomography

VF:

Ventricular fibrillation

VT:

Ventricular tachycardia

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, Münster, 48149, Germany

    Alexis Vrachimis, Michael Schäfers, Lars Stegger & Christian Wenning

  2. European Institute for Molecular Imaging, University of Münster, Mendelstraße 11, Building L1, 4th floor, Münster, 48149, Germany

    Alexis Vrachimis & Michael Schäfers

Authors
  1. Alexis Vrachimis
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  2. Michael Schäfers
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  3. Lars Stegger
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  4. Christian Wenning
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Correspondence to Alexis Vrachimis .

Editor information

Editors and Affiliations

  1. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Riemer H.J.A. Slart

  2. Thorax center Cardiology, University Medical Center Groningen, Groningen, The Netherlands

    René A. Tio

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Philip H. Elsinga

  4. Nuklearmedizinische Klinik, Klinikum Rechts der Isar Technische Universität München, München, Germany

    Markus Schwaiger

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Vrachimis, A., Schäfers, M., Stegger, L., Wenning, C. (2015). Autonomic Imaging in Ventricular Arrhythmias. In: Slart, R., Tio, R., Elsinga, P., Schwaiger, M. (eds) Autonomic Innervation of the Heart. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45074-1_18

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  • DOI: https://doi.org/10.1007/978-3-662-45074-1_18

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