MRI-guided ventricular tachycardia ablation integration of late gadolinium-enhanced 3D scar in patients with implantable cardioverter- defibrillators

Timm Dickfeld, Jing Tian, Ghada Ahmad, Alejandro Jimenez, Aharon Turgeman, Richard Kuk, Matthew Peters, Anastasios Saliaris, Magdi Saba, Stephen Shorofsky, Jean Jeudy

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)172-184
Number of pages13
JournalCirculation: Arrhythmia and Electrophysiology
Volume4
Issue number2
DOIs
StatePublished - Apr 2011
Externally publishedYes

Keywords

  • Ablation
  • Implantable cardioverter-defibrillators
  • Magnetic resonance imaging
  • Tachycardia ventricular

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

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