Three-dimensional contrast-enhanced multidetector CT for anatomic, dynamic, and perfusion characterization of abnormal myocardium to guide ventricular tachycardia ablations

Jing Tian, Jean Jeudy, Mark F. Smith, Alejandro Jimenez, Xianghua Yin, Patricia A. Bruce, Peng Lei, Aharon Turgeman, Aharon Abbo, Raj Shekhar, Magdi Saba, Stephen Shorofsky, Timm Dickfeld

Research output: Contribution to journalArticlepeer-review

Abstract

Background-Advances in contrast-enhanced multidetector CT enable detailed characterization of the left ventricular myocardium. Myocardial scar and border zone (BZ), as the target of ventricular tachycardia ablations, displays abnormal anatomic, dynamic, and perfusion characteristics during first-pass CT. This study assessed how contrast-enhanced CT can predict voltage-defined scar and BZ and integrate its scar reconstructions into clinical mapping systems to guide ventricular tachycardia ablations. Methods and Results-Eleven patients with ischemic cardiomyopathy underwent contrast-enhanced CT before ventricular tachycardia ablation. Segmental anatomic (end-systolic and end-diastolic wall thickness), dynamic (wall thickening, wall motion), and perfusion (hypoenhancement) characteristics were evaluated. Receiver operating characteristic curves assessed the ability of CT to determine voltage-defined scar and BZ segments. Three-dimensional epi- and endocardial surfaces and scar borders were reconstructed, coregistered, and compared to voltages using a 17-segment model. Abnormal anatomic, dynamic, and perfusion data correlated well with abnormal (

Original languageEnglish (US)
Pages (from-to)496-504
Number of pages9
JournalCirculation: Arrhythmia and Electrophysiology
Volume3
Issue number5
DOIs
StatePublished - Oct 2010
Externally publishedYes

Keywords

  • Ablation techniques
  • Computerized emission tomography
  • Image processing computer assisted
  • Imaging three-dimensional
  • Tachycardia ventricular

ASJC Scopus subject areas

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

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