Computational Identification of Ventricular Arrhythmia Risk in Pediatric Myocarditis

Mark J. Cartoski, Plamen P. Nikolov, Adityo Prakosa, Patrick M. Boyle, Philip J Spevak, Natalia A. Trayanova

Research output: Contribution to journalArticle

Abstract

Children with myocarditis have increased risk of ventricular tachycardia (VT) due to myocardial inflammation and remodeling. There is currently no accepted method for VT risk stratification in this population. We hypothesized that personalized models developed from cardiac late gadolinium enhancement magnetic resonance imaging (LGE-MRI) could determine VT risk in patients with myocarditis using a previously-validated protocol. Personalized three-dimensional computational cardiac models were reconstructed from LGE-MRI scans of 12 patients diagnosed with myocarditis. Four patients with clinical VT and eight patients without VT were included in this retrospective analysis. In each model, we incorporated a personalized spatial distribution of fibrosis and myocardial fiber orientations. Then, VT inducibility was assessed in each model by pacing rapidly from 26 sites distributed throughout both ventricles. Sustained reentrant VT was induced from multiple pacing sites in all patients with clinical VT. In the eight patients without clinical VT, we were unable to induce sustained reentry in our simulations using rapid ventricular pacing. Application of our non-invasive approach in children with myocarditis has the potential to correctly identify those at risk for developing VT.

Original languageEnglish (US)
JournalPediatric Cardiology
DOIs
StatePublished - Jan 1 2019

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Myocarditis
Ventricular Tachycardia
Cardiac Arrhythmias
Pediatrics
Gadolinium
Magnetic Resonance Imaging
Fibrosis
Inflammation

Keywords

  • Arrhythmia
  • Computational
  • Electrophysiology
  • MRI
  • Myocarditis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Computational Identification of Ventricular Arrhythmia Risk in Pediatric Myocarditis. / Cartoski, Mark J.; Nikolov, Plamen P.; Prakosa, Adityo; Boyle, Patrick M.; Spevak, Philip J; Trayanova, Natalia A.

In: Pediatric Cardiology, 01.01.2019.

Research output: Contribution to journalArticle

Cartoski, Mark J. ; Nikolov, Plamen P. ; Prakosa, Adityo ; Boyle, Patrick M. ; Spevak, Philip J ; Trayanova, Natalia A. / Computational Identification of Ventricular Arrhythmia Risk in Pediatric Myocarditis. In: Pediatric Cardiology. 2019.
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