Role of CMR imaging in risk stratification for sudden cardiac death

Left ventricular ejection fraction as determined by echocardiography has a limited sensitivity in predicting risk for sudden cardiac death (SCD). Subsequent efforts to improve cost-effectiveness of device implantation and identify a better risk-stratifying tool have been quite desirable. The presence of scar and myocardial tissue heterogeneity has been linked to ventricular arrhythmia, which is believed to be the major cause of SCD. Cardiac magnetic resonance is a noninvasive imaging modality that visualizes and quantifies scar, with growing evidence delineating its additive value in identifying patients at higher risk for SCD.