Prognostic Value of Cardiac MRI in ARVC/D

This Chapter provides practical considerations with regard to the use of CMR for prognosis and follow up in ARVC/D. CMR is an important prognostic tool and an excellent modality for effective risk stratification of patients with known or suspected ARVC/D. Using advanced methodology, CMR may reveal subtle changes in the right ventricular function, geometry, and structure well before the RVEF is compromised. In patients with phenotype positivity, CMR may be helpful in establishing the diagnosis and provide reliable longitudinal follow-up. Since electrical abnormalities precede detectable structural changes, the use of serial CMR screening may be restricted to symptomatic family members with electrical abnormalities on ECG and Holter monitoring. CMR has excellent spatial resolution and inter- and intraobserver variability and thus is an effective tool for sequential imaging. Based on published literature, the majority of the patients should be rescanned not sooner than every 4 years, unless new symptoms develop.