Use of self-gated radial cardiovascular magnetic resonance to detect and classify arrhythmias (atrial fibrillation and premature ventricular contraction)

Abstract

BackgroundArrhythmia can significantly alter the image quality of cardiovascular magnetic resonance (CMR); automatic detection and sorting of the most frequent types of arrhythmias during the CMR acquisition could potentially improve image quality. New CMR techniques, such as non-Cartesian CMR, can allow self-gating: from cardiac motion-related signal changes, we can detect cardiac cycles without an electrocardiogram. We can further use this data to obtain a surrogate for RR intervals (valley intervals: VV). Our purpose was to evaluate the feasibility of an automated method for classification of non-arrhythmic (NA) (regular cycles) and arrhythmic patients (A) (irregular cycles), and for sorting of common arrhythmia patterns between atrial fibrillation (AF) and premature ventricular contraction (PVC), using the cardiac motion-related signal obtained during self-gated free-breathing radial cardiac cine CMR with compressed sensing reconstruction (XD-GRASP).MethodsOne hundred eleven patients underwent cardiac XD-GRASP CMR between October 2015 and February 2016; 33 were included for retrospective analysis with the proposed method (6 AF, 8 PVC, 19 NA; by recent ECG). We analyzed the VV, using pooled statistics (histograms) and sequential analysis (Poincaré plots), including the median (medVV), the weighted mean (meanVV), the total number of VV values (VVval), and the total range (VVTR) and half range (VVHR) of the cumulative frequency distribution of VV, including the median to half range (medVV/VVHR) and the half range to total range (VVHR/VVTR) ratios. We designed a simple algorithm for using the VV results to differentiate A from NA, and AF from PVC.ResultsBetween NA and A, meanVV, VVval, VVTR, VVHR, medVV/VVHR and VVHR/VVTR ratios were significantly different (p values = 0.00014, 0.0027, 0.000028, 5×10−9, 0.002, respectively). Between AF and PVC, meanVV, VVval and medVV/VVHR ratio were significantly different (p values = 0.018, 0.007, 0.044, respectively). Using our algorithm, sensitivity, specificity, and accuracy were 93 %, 95 % and 94 % to discriminate between NA and A, and 83 %, 71 %, and 77 % to discriminate between AF and PVC, respectively; areas under the ROC curve were 0.93 and 0.89.ConclusionsOur study shows we can reliably detect arrhythmias and differentiate AF from PVC, using self-gated cardiac cine XD-GRASP CMR.

Age-Related Alterations in Brain Perfusion, Venous Oxygenation, and Oxygen Metabolic Rate of Mice: A 17-Month Longitudinal MRI Study

“…We therefore utilized a MRI sequence to perform in-scanner measurement of heart rate during each session. The sequence acquired the center k-space repeatedly at an interval of 8.0 ms, thereby yielding a time course of MR signal intensity, the period of which is the R-R interval (49). Two measurements were performed in each session and the values were averaged.…”

5D whole‐heart sparse MRI

“…This approach does not rely on assumptions about motion models (e.g., translation, affine, or nonrigid) as in registration‐based correction methods, maintains high scan efficiency, and provides access to additional physiologic information of potential clinical value . Successful applications of XD‐GRASP have been demonstrated for free‐breathing liver MRI , whole‐heart coronary MRA and cardiac cine MRI .…”

Using 5D flow MRI to decode the effects of rhythm on left atrial 3D flow dynamics in patients with atrial fibrillation

“…Piekarski et al previously reported a similar measure of self-gating signal that could separate non-arrhythmic patients from arrhythmic patients. 37 While Piekarski does not report an AF burden threshold for low versus high AF burden, their results suggest a threshold of just under 17.0%, a value that is close to the AF burden of the least arrhythmic patient with persistent AF (Table 1, subject 19). We investigated splitting patients into groups of persistent/permanent AF versus paroxysmal AF (PAF), and found it preserved the hemodynamic relationships seen between low and high AF burden.…”