Cardiac MRI with metric optimized gating in pediatric patients with ventricular bigeminy

Cardiovascular magnetic resonance cine imaging is limited in patients with an irregular cardiac rhythm as electrocardiographic gating requires a regular rhythm during image data acquisition. We describe a novel approach for imaging pediatric patients with ventricular bigeminy, using artificial triggering followed by metric optimized gating (MOG) reconstruction. This technique allows for the reconstruction of diagnostic quality images and permits quantitative flow and volumetric analyses. Unlike conventional methods of arrhythmia suppression or exclusion, this technique preserves the abnormal arrhythmic cycle, enabling a more comprehensive understanding of the patient's true hemodynamic physiology.