New insight into scar-related ventricular tachycardia circuits in ischemic cardiomyopathy: Fat deposition after myocardial infarction on computed tomography - A pilot study

Takeshi Sasaki, Hugh Calkins, Christopher Miller, Menekhem M. Zviman, Vadim Zipunnikov, Tomio Arai, Motoji Sawabe, Masashiro Terashima, Joseph Marine, Ronald D Berger, Saman Nazarian, Stefan Zimmerman

Research output: Contribution to journalArticle

Abstract

Background Myocardial fat deposition (FAT-DEP) has been frequently observed in regions of chronic myocardial infarction in patients with ischemic cardiomyopathy. The role of FAT-DEP within scar-related ventricular tachycardia (VT) circuits has not been investigated. Objective This pilot study aimed to assess the impact of myocardial FAT-DEP on local electrograms and VT circuits in patients with ischemic cardiomyopathy. Methods Contrast-enhanced computed tomography was performed in 22 patients with ischemic VT. Electroanatomic map points were registered to the corresponding contrast-enhanced computed tomography images. Myocardial FAT-DEP was identified and characterized using a postprocessing image overlay that highlighted areas below 0 Hounsfield units (HU). The mean attenuation of local myocardial regions corresponding to sampled electrograms was measured on short-axis images. The associations of mean attenuation with bipolar and unipolar amplitudes, left ventricular wall thickness, and VT circuit sites were investigated. Results Of 1801 electroanatomic map points, 519 (28.8%) were located in regions with FAT-DEP. Significant differences were observed in mean intensity (23.2 ± 35.6 HU vs 81.7 ± 21.9 HU; P

Original languageEnglish (US)
Pages (from-to)1508-1518
Number of pages11
JournalHeart Rhythm
Volume12
Issue number7
DOIs
StatePublished - Jul 1 2015

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Ventricular Tachycardia
Cardiomyopathies
Cicatrix
Fats
Myocardial Infarction
Tomography

Keywords

  • Computed tomography
  • Fat
  • Ischemic cardiomyopathy
  • Magnetic resonance imaging
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

New insight into scar-related ventricular tachycardia circuits in ischemic cardiomyopathy : Fat deposition after myocardial infarction on computed tomography - A pilot study. / Sasaki, Takeshi; Calkins, Hugh; Miller, Christopher; Zviman, Menekhem M.; Zipunnikov, Vadim; Arai, Tomio; Sawabe, Motoji; Terashima, Masashiro; Marine, Joseph; Berger, Ronald D; Nazarian, Saman; Zimmerman, Stefan.

In: Heart Rhythm, Vol. 12, No. 7, 01.07.2015, p. 1508-1518.

Research output: Contribution to journalArticle

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AU - Zviman, Menekhem M.

AU - Zipunnikov, Vadim

AU - Arai, Tomio

AU - Sawabe, Motoji

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