Cardiac CT With Delayed Enhancement in the Characterization of Ventricular Tachycardia Structural Substrate. Relationship Between CT-Segmented Scar and Electro-Anatomic Mapping

Antonio Esposito, Anna Palmisano, Sofia Antunes, Giuseppe Maccabelli, Caterina Colantoni, Paola Maria Vittoria Rancoita, Francesca Baratto, Clelia Di Serio, Giovanna Rizzo, Francesco De Cobelli, Paolo Della Bella, Alessandro Del Maschio

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: This study sought to compare myocardial scars depicted by computed tomography (CT) with electrical features from electro-anatomic mapping (EAM), assessing the potential role of CT integration in ventricular tachycardia (VT) and radiofrequency catheter ablation (RFCA) procedures. Background: Imaging-based characterization of VT myocardial substrate is required to plan EAM and, potentially, to guide RFCA. Methods: Forty-two consecutive patients, 35 of whom had implantable cardioverter-defibrillator, all referred for VT RFCA, underwent pre-procedural CT including an angiographic and a 10-min delayed-enhancement scan. Segmental comparison between scars segmented from CT and low voltages (bipolar voltages 2, bipolar voltages -EAM = 4,070 mm2; R = 0.78; p <0.0001). In this study, 70% and 84% of low-amplitude bipolar points were mapped at a maximum distance of 5 mm and 10 mm from CT-segmented scar, respectively. Conclusions: CT with delayed-enhancement provides a 3-dimensional characterization of VT scar substrate together with a detailed anatomic model of the heart. This information may offer assistance to plan EAM and RFCA procedures and is potentially suitable for EAM-imaging integration.

Original languageEnglish
JournalJACC: Cardiovascular Imaging
DOIs
Publication statusAccepted/In press - May 4 2015

Keywords

  • Cardiac computed tomography
  • Computed tomography delayed enhancement
  • Electro-anatomic mapping
  • Radiofrequency catheter ablation
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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