Diagnostic performance with native T1 mapping was superior to that with T2 ratio and early gadolinium enhancement ratio, and specificity was higher with native T1 mapping than that with Lake Louise criteria. This study underlines the potential of native T1 relaxation times to complement current cardiac MR approaches in patients suspected of having acute myocarditis.

CRT-Ds and an elevated percentage of VP are associated with a significantly elevated risk for device replacement, while Medtronic ICDs showed the longest lifespans.

No abstract

Approximately 30% of implantable cardioverter defibrillator (ICD) patients still die of sudden death. A major cause of these sudden deaths is the failure to defibrillate because of failure to achieve a low defibrillation threshold (DFT). Anti‐arrhythmic drugs can have a profound positive or negative effect on the DFT. Unfortunately, present clinical practice continues to feature many procedures and tactics that have minimal to negative DFT benefit. In addition, many demonstrated helpful tactics are not understood or followed. This review covers the optimal RV (right ventricular) coil position and polarity, superior vena cava (SVC) coil positioning and usage, pulse width settings, and azygous vein coil implants. Specifically, the RV coil should be set to an anodal polarity and never ‘reversed’. The optimal RV coil position appears to be along the mid‐septum. The SVC coil should be kept out of the right atrium and placed in the innominate vein junction. The SVC coil should be always on for high impedance patients. For low impedance patients, the SVC coil should be set on or off depending on which setting gives the lowest DFT. Pulse widths should be set to correspond to optimally charging and discharging a cardiac membrane time constant of between 3.5 and 4.5 ms. For the highest DFT patients, a separate coil should be placed in the azygous vein and connected to the ICD ‘SVC’ port. Anachronistic approaches such as the use of polarity reversal, apical RV coil tip forcing, and subcutaneous arrays are also discussed.

Early post-MI patients at high risk of sudden cardiac death may benefit from WCD therapy.