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SHR Neuro Cancer Cardio Lipid Metab Microb

Bhagirath, P; Campos, FO; Costa, CM; Wilde, AAM; Prassl, AJ; Neic, A; Plank, G; Rinaldi, CA; Götte, MJW; Bishop, MJ.
Predicting arrhythmia recurrence following catheter ablation for ventricular tachycardia using late gadolinium enhancement magnetic resonance imaging: Implications of varying scar ranges.
Heart Rhythm. 2022; 19(10):1604-1610 Doi: 10.1016/j.hrthm.2022.05.021 [OPEN ACCESS]
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Co-authors Med Uni Graz

Campos Fernando Otaviano

Mendonca Costa Caroline

Neic Aurel-Vasile

Plank Gernot

Prassl Anton

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Abstract:

BACKGROUND: Thresholding-based analysis of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) can create scar maps and identify corridors that might provide a reentrant substrate for ventricular tachycardia (VT). Current recommendations use a full-width-at-half-maximum approach, effectively classifying areas with a pixel signal intensity (PSI) >40% as border zone (BZ) and >60% as core. OBJECTIVE: The purpose of this study was to investigate the impact of 4 different threshold settings on scar and corridor quantification and to correlate this with postablation VT recurrence. METHODS: Twenty-seven patients with ischemic cardiomyopathy who had undergone catheter ablation for VT were included for retrospective analysis. LGE-CMR images were analyzed using ADAS3D LV. Scar maps were created for 4 PSI thresholds (40-60, 35-65, 30-70, and 45-55), and the extent of variation in BZ and core, as well as the number and weight of conduction corridors, were quantified. Three-dimensional representations were reconstructed from exported segmentations and used to quantify the surface area between healthy myocardium and scar (BZ + core), and between BZ and core. RESULTS: A wider PSI threshold was associated with an increase in BZ mass and decrease in scar (P <.001). No significant differences were observed for the total number of corridors and their mass with increasing PSI threshold. The best correlation in predicting arrhythmia recurrence was observed for PSI 45-55 (area under the curve 0.807; P = .001). CONCLUSION: Varying PSI has a significant impact on quantification of LGE-CMR parameters and may have incremental clinical value in predicting arrhythmia recurrence. Further prospective investigation is warranted to clarify the functional implications of these findings for LGE-CMR-guided ventricular ablation.

Find related publications in this database (using NLM MeSH Indexing)

Catheter Ablation - methods

Cicatrix - diagnosis, etiology, pathology

Contrast Media - pharmacology

Gadolinium - pharmacology

Humans - administration & dosage

Magnetic Resonance Imaging - methods

Magnetic Resonance Spectroscopy - administration & dosage

Retrospective Studies - administration & dosage

Tachycardia, Ventricular - diagnosis, pathology, surgery

Find related publications in this database (Keywords)

Arrhythmia recurrence

Cardiac magnetic resonance imaging

Catheter ablation

Late enhancement magnetic resonance imaging

Ventricular tachycardia

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