Applications of Advanced Imaging in Cardiac Electrophysiology

Imaging modalities such as computed tomography, magnetic resonance, positron emission tomography, and single-photon emission computed tomography are an indispensable component of cardiac arrhythmia management. Over the last two decades, developments in imaging techniques have facilitated safer and more effective cardiac ablation and device implantation procedures. Pre-procedural assessment of arrhythmogenic substrate and integration with electroanatomic data has significantly impacted the management of atrial fibrillation and ventricular tachycardia. Furthermore, cardiovascular imaging enhances patient selection, prognostication, and follow-up of patients undergoing ablation procedures. Imaging also provides valuable anatomic information in patients being considered for cardiac resynchronization therapy (CRT). While the optimal modality for assessing efficacy of resynchronization is currently unclear, further study holds promise in mitigating the substantial burden of CRT non-response. This article aims to highlight the utility and evidence for various advanced imaging modalities in the practice of cardiac electrophysiology with an emphasis on recent developments and future directions.