TY - JOUR
T1 - MRI-guided ventricular tachycardia ablation integration of late gadolinium-enhanced 3D scar in patients with implantable cardioverter- defibrillators
AU - Dickfeld, Timm
AU - Tian, Jing
AU - Ahmad, Ghada
AU - Jimenez, Alejandro
AU - Turgeman, Aharon
AU - Kuk, Richard
AU - Peters, Matthew
AU - Saliaris, Anastasios
AU - Saba, Magdi
AU - Shorofsky, Stephen
AU - Jeudy, Jean
PY - 2011/4
Y1 - 2011/4
N2 - Background-Substrate-guided ablation of ventricular tachycardia (VT) in patients with implanted cardioverterdefibrillators (ICDs) relies on voltage mapping to define the scar and border zone. An integrated 3D scar reconstruction from late gadolinium enhancement (LGE) MRI could facilitate VT ablations. Methods and Results-Twenty-two patients with ICD underwent contrast-enhanced cardiac MRI with a specific absorption rate of 2 mm resulted in >1.5-mV voltage recordings despite up to 63% transmural midmyocardial scar successfully ablated with MRI guidance. All successful ablation sites demonstrated LGE (transmurality, 68±26%) and were located within 10 mm of transition zones to 0% to 25% scar in 71%. Conclusions-Contrast-enhanced cardiac MRI can be safely performed in selected patients with ICDs and allows the integration of detailed 3D scar maps into clinical mapping systems, providing supplementary anatomic guidance to facilitate substrate-guided VT ablations.
AB - Background-Substrate-guided ablation of ventricular tachycardia (VT) in patients with implanted cardioverterdefibrillators (ICDs) relies on voltage mapping to define the scar and border zone. An integrated 3D scar reconstruction from late gadolinium enhancement (LGE) MRI could facilitate VT ablations. Methods and Results-Twenty-two patients with ICD underwent contrast-enhanced cardiac MRI with a specific absorption rate of 2 mm resulted in >1.5-mV voltage recordings despite up to 63% transmural midmyocardial scar successfully ablated with MRI guidance. All successful ablation sites demonstrated LGE (transmurality, 68±26%) and were located within 10 mm of transition zones to 0% to 25% scar in 71%. Conclusions-Contrast-enhanced cardiac MRI can be safely performed in selected patients with ICDs and allows the integration of detailed 3D scar maps into clinical mapping systems, providing supplementary anatomic guidance to facilitate substrate-guided VT ablations.
KW - Ablation
KW - Implantable cardioverter-defibrillators
KW - Magnetic resonance imaging
KW - Tachycardia ventricular
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U2 - 10.1161/CIRCEP.110.958744
DO - 10.1161/CIRCEP.110.958744
M3 - Article
C2 - 21270103
AN - SCOPUS:79958827075
SN - 1941-3149
VL - 4
SP - 172
EP - 184
JO - Circulation: Arrhythmia and Electrophysiology
JF - Circulation: Arrhythmia and Electrophysiology
IS - 2
ER -