Late gadolinium enhancement cardiac magnetic resonance imaging of ablation lesions after postinfarction ventricular tachycardia ablation: Implications for ventricular tachycardia recurrence.
cardiac magnetic resonance imaging
catheter ablation
ischemic cardiomyopathy
repeat catheter ablation
ventricular tachycardia
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
revised:
06
11
2021
received:
31
07
2021
accepted:
09
12
2021
pubmed:
24
1
2022
medline:
5
4
2022
entrez:
23
1
2022
Statut:
ppublish
Résumé
Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging distinguishes between intrinsic postinfarction scar and radiofrequency ablation lesion related scar (dark core lesions [DCLs]) in patients with prior ventricular tachycardia (VT) ablation procedures. To combine LGE-CMR and electroanatomic mapping data to describe the relationship between DCLs and recurrent VT among patients undergoing repeat ablations for postinfarction VT. Consecutive patients with repeat ablation for postinfarct VT with LGE-CMR before the repeat procedures were studied. Prior ablation procedures and implantable cardiac defibrillator electrograms were analyzed to determine new versus previously documented VT. DCLs were identified on preprocedure LGE-CMR and registered to electroanatomic maps. A control group of patients undergoing repeat ablation procedures without imaging was included. Nineteen study patients and 14 control patients were followed for 2.6 (1.6-5.6) years (31 [94%] men, age 65.8 ± 8.4 years, ejection fraction 24.7 ± 10.3, p > 0.10 for all). DCLs corresponded to unexcitable tissue during repeat procedures (area 22.4 ± 15.1 vs. 22.9 ± 16.8 cm LGE-MRI can identify prior ablation lesions corresponding to nonexcitable tissue during repeat ablation procedures for postinfarction VT. VT target sites are often located in close proximity to the DCL area that may function as a fixed border for reentry circuits. Registration of DCL from prior ablation may facilitate repeat ablation procedures.
Sections du résumé
BACKGROUND
Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging distinguishes between intrinsic postinfarction scar and radiofrequency ablation lesion related scar (dark core lesions [DCLs]) in patients with prior ventricular tachycardia (VT) ablation procedures.
OBJECTIVE
To combine LGE-CMR and electroanatomic mapping data to describe the relationship between DCLs and recurrent VT among patients undergoing repeat ablations for postinfarction VT.
METHODS
Consecutive patients with repeat ablation for postinfarct VT with LGE-CMR before the repeat procedures were studied. Prior ablation procedures and implantable cardiac defibrillator electrograms were analyzed to determine new versus previously documented VT. DCLs were identified on preprocedure LGE-CMR and registered to electroanatomic maps. A control group of patients undergoing repeat ablation procedures without imaging was included.
RESULTS
Nineteen study patients and 14 control patients were followed for 2.6 (1.6-5.6) years (31 [94%] men, age 65.8 ± 8.4 years, ejection fraction 24.7 ± 10.3, p > 0.10 for all). DCLs corresponded to unexcitable tissue during repeat procedures (area 22.4 ± 15.1 vs. 22.9 ± 16.8 cm
CONCLUSION
LGE-MRI can identify prior ablation lesions corresponding to nonexcitable tissue during repeat ablation procedures for postinfarction VT. VT target sites are often located in close proximity to the DCL area that may function as a fixed border for reentry circuits. Registration of DCL from prior ablation may facilitate repeat ablation procedures.
Substances chimiques
Contrast Media
0
Gadolinium
AU0V1LM3JT
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
715-721Subventions
Organisme : French National Research Agency
ID : ANR-11-EQPX-0030
Organisme : French National Research Agency
ID : IHU LIRYC ANR-10-IAHU-04
Organisme : French National Research Agency
ID : MIGAT ANR-13-PRTS-0014-01
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022 Wiley Periodicals LLC.
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