TY - JOUR
T1 - Cardiac CT With Delayed Enhancement in the Characterization of Ventricular Tachycardia Structural Substrate. Relationship Between CT-Segmented Scar and Electro-Anatomic Mapping
AU - Esposito, Antonio
AU - Palmisano, Anna
AU - Antunes, Sofia
AU - Maccabelli, Giuseppe
AU - Colantoni, Caterina
AU - Rancoita, Paola Maria Vittoria
AU - Baratto, Francesca
AU - Di Serio, Clelia
AU - Rizzo, Giovanna
AU - De Cobelli, Francesco
AU - Della Bella, Paolo
AU - Del Maschio, Alessandro
PY - 2015/5/4
Y1 - 2015/5/4
N2 - 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.
AB - 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.
KW - Cardiac computed tomography
KW - Computed tomography delayed enhancement
KW - Electro-anatomic mapping
KW - Radiofrequency catheter ablation
KW - Ventricular tachycardia
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U2 - 10.1016/j.jcmg.2015.10.024
DO - 10.1016/j.jcmg.2015.10.024
M3 - Article
AN - SCOPUS:84958580535
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
SN - 1936-878X
ER -