Are wall thickness channels defined by computed tomography predictive of isthmuses of postinfarction ventricular tachycardia?

Cicatrix / physiopathology Contrast Media Electrophysiologic Techniques, Cardiac Female Heart Conduction System / physiopathology Humans Imaging, Three-Dimensional Male Middle Aged Myocardial Infarction / complications Retrospective Studies Tachycardia, Ventricular / diagnostic imaging Tomography, X-Ray Computed / methods

Contrast-enhanced multidetector computed tomography High-resolution mapping Isthmus MUSIC Myocardial infarction Ventricular tachycardia Wall thickness

Journal

Heart rhythm

ISSN: 1556-3871

Titre abrégé: Heart Rhythm

Pays: United States

ID NLM: 101200317

Informations de publication

Date de publication:
11 2019

Historique:

received: 02 04 2019

pubmed: 18 6 2019

medline: 15 12 2020

entrez: 18 6 2019

Statut: ppublish

Résumé

Wall thickness (WT) in post-myocardial infarction scar is heterogenous, with channels of relatively preserved thickness bordered by thinner scar. This study sought to determine whether 3-dimensionally-reconstructed computed tomography (CT) channels correlate with electrophysiological isthmuses during ventricular tachycardia (VT). We retrospectively studied 9 postinfarction patients (aged 57 ± 15 years, 1 female) with 10 complete VT activation maps (cycle length 429 ± 77ms) created using high-resolution mapping. Three-dimensionally-reconstructed WT maps from CT were merged with the activation map during sinus rhythm (SR) and VT. The relationship between WT and electrophysiological characteristics was analyzed. A total of 41 CT channels were identified (median 4 per patient), of median (range) length 21.2 mm (17.3-36.8 mm), width 9.0 mm (6.7-16.5 mm), and area 1.49 cm VT isthmuses were always found in CT channels (100% sensitivity), and half of CT channels hosted VT isthmuses (positive predictive value 51%). Longer and thinner (but >1 mm) CT channels were significantly associated with VT isthmuses.

Sections du résumé

BACKGROUND

Wall thickness (WT) in post-myocardial infarction scar is heterogenous, with channels of relatively preserved thickness bordered by thinner scar.

OBJECTIVE

This study sought to determine whether 3-dimensionally-reconstructed computed tomography (CT) channels correlate with electrophysiological isthmuses during ventricular tachycardia (VT).

METHODS

We retrospectively studied 9 postinfarction patients (aged 57 ± 15 years, 1 female) with 10 complete VT activation maps (cycle length 429 ± 77ms) created using high-resolution mapping. Three-dimensionally-reconstructed WT maps from CT were merged with the activation map during sinus rhythm (SR) and VT. The relationship between WT and electrophysiological characteristics was analyzed.

RESULTS

A total of 41 CT channels were identified (median 4 per patient), of median (range) length 21.2 mm (17.3-36.8 mm), width 9.0 mm (6.7-16.5 mm), and area 1.49 cm

CONCLUSION

VT isthmuses were always found in CT channels (100% sensitivity), and half of CT channels hosted VT isthmuses (positive predictive value 51%). Longer and thinner (but >1 mm) CT channels were significantly associated with VT isthmuses.

Identifiants

DOI: 10.1016/j.hrthm.2019.06.012 PMID: 31207315

pubmed: 31207315

pii: S1547-5271(19)30557-0

doi: 10.1016/j.hrthm.2019.06.012

pii:

doi:

Substances chimiques

Contrast Media 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

1661-1668

Subventions

Organisme : British Heart Foundation

ID : FS/16/71/32487

Pays : United Kingdom