Sudden cardiac death: Risk stratification using cardiac MRI

Sudden cardiac death (SCD) is recognised as a public health problem and can be caused by multiple heart diseases, which vary depending on the age of the patient. SCD risk stratification is a controversial topic surrounded by debate, since it is not easy to determine the appropriate timing for implanting an automatic defibrillator. Given that arrhythmic events are associated with myocardial scars, SCD stratification should go beyond the assessment of systolic function. Cardiac magnetic resonance imaging (MRI) plays a fundamental role since it enables the non-invasive characterisation of macroscopic and interstitial myocardial fibrosis, revealing the pattern and extent. This article reviews the role of cardiac MRI in SCD risk prediction.