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.
- Implantable cardioverter-defibrillators
- Magnetic resonance imaging
- Tachycardia ventricular
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)