MR Imaging of Myocardial Scar, with Electrophysiology Applications

This article reviews the increasing role of cardiac MR imaging to quantitatively assess myocardial scar in the context of clinical cardiac electrophysiology. After a quick overview of the biologic aspects of myocardial scar, two imaging techniques currently used to routinely image scar in cardiac electrophysiology contexts are described, MR imaging and electroanatomic mapping, and their relationship is explained. The main clinical issues involving MR imaging for cardiac electrophysiology are then reviewed, including imaging in cardiomyopathy (both ischemic and nonischemic), imaging for cardiac ablation therapy, and imaging of subjects with intracardiac devices.