Image-Based Prediction of Ventricular Tachycardias in Post-Myocarditis Patients: an International Multicenter Case-control Study

Research hypothesis

The composite outcome is:

• sudden cardiac death, sustained VT, syncopal VT or appropriate ICD therapy (ATP and/or shock) in ICD carriers in primary prevention, or
• sudden cardiac death, sustained VT, syncopal VT detected by any diagnostic test (i.e., 24 h Holter monitoring, prolonged Holter monitoring, urgency ECG etc.) in no ICD-carriers.

Our research hypothesis is that the composite outcome will be higher in those patients with greater scar mass and BZC mass.

Primary objective To analyze the composite outcome of sudden cardiac death or sustained ventricular tachycardia (either treated by an ICD or documented by any diagnostic method) in post-myocarditis patients with no previous arrhythmia evidence, according to their risk classification by means of BZC mass.

Secondary objectives

To analyze the relationship between the primary outcome and other variables:

• LVEF
• Scar mass
• BZ mass
• Core mass
• Presence and number of tissue channels within the scar, as detected by cardiac CT
• Age
• Time since myocarditis

Inclusion criteria

• Age > 18 years.
• Myocarditis diagnosis > 6 months before the inclusion in the study.
• Signed informed consent.
• CMR performed > 6 months after myocarditis diagnosis

Exclusion criteria

• Age < 18 years.
• Pregnancy.
• Other concomitant structural heart diseases (e.g. congenital, non-ischemic, etc.)
• Active myocarditis
• Myocarditis diagnosis < 6 months
• Previously documented sustained ventricular arrhythmias.
• Impossibility or contraindications to undergo LGE-CMR.
• Concomitant investigation treatments.
• Medical, geographical and social factors that make study participation impractical, and inability to give written informed consent. Patient's refusal to participate in the study.