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Ventricular tachycardia ablation after myocardial infarction guided by cardiac magnetic resonance/multidetector computed tomography image integration

Alexandru – Paul Burcin
Alexandru – Paul Burcin
, 
Lucian Câlmâc
Lucian Câlmâc
, 
Smǎrǎndiţa loana Lǎcǎu
Smǎrǎndiţa loana Lǎcǎu
, 
Tudor Șarpe
Tudor Șarpe
, 
Viviana Gondoș
Viviana Gondoș
, 
David Sotto-Iglesias
David Sotto-Iglesias
, 
Antonio Berruezo
Antonio Berruezo
 et 
Radu-Gabriel Vătășescu
Radu-Gabriel Vătășescu
   | 29 mars 2024
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Article Category: Review
Publié en ligne: 29 mars 2024
Pages: 7 - 15
DOI: https://doi.org/10.2478/rjc-2024-0004
Mots clés
© 2024 Alexandru – Paul Burcin et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

12-lead ECG – Wide complex QRS tachycardia, 180/min; RBBB morphology, right-axis deviation suggestive for anterolateral LV exit-site
12-lead ECG – Wide complex QRS tachycardia, 180/min; RBBB morphology, right-axis deviation suggestive for anterolateral LV exit-site

Figure 2A

Coronary angiogram and FFR measurements – subocclusion of OM 1 (middle segment); 50 % middle LAD stenosis (FFR – 0.73); 50-60 % proximal LCx stenosis (FFR – 0.76)
Coronary angiogram and FFR measurements – subocclusion of OM 1 (middle segment); 50 % middle LAD stenosis (FFR – 0.73); 50-60 % proximal LCx stenosis (FFR – 0.76)

Figure 2B

Coronary angiogram after implantation of 3 drug-elluting stents (middle LAD, proximal LCx and middle OM1)
Coronary angiogram after implantation of 3 drug-elluting stents (middle LAD, proximal LCx and middle OM1)

Figure 3

Cardiac MRI – Mild LV dilation; LVEF – 43 %; Multiple areas of LGE along the middle third of antero-lateral and lateral wall
Cardiac MRI – Mild LV dilation; LVEF – 43 %; Multiple areas of LGE along the middle third of antero-lateral and lateral wall

Figure 4

Multimodal image integration. Right: Fusion between MDCT and LGE-CMR PSI Map (ADAS 3D Software). Left: Integration with EAM (Biosense – Webster Carto 3 Navigation System)
Multimodal image integration. Right: Fusion between MDCT and LGE-CMR PSI Map (ADAS 3D Software). Left: Integration with EAM (Biosense – Webster Carto 3 Navigation System)

Figure 5

Substrate-based RF ablation targeting conduction channels (CC) identified on fusion imaging concordant with fractionated and late potentials on EAM
Substrate-based RF ablation targeting conduction channels (CC) identified on fusion imaging concordant with fractionated and late potentials on EAM

Figure 6

EGMs before and after RF ablation showing fragmented potential abolition at the conducting channel entry
EGMs before and after RF ablation showing fragmented potential abolition at the conducting channel entry

Figure 7

Ventricular programmed stimulation with 4 ES – complete non-inducibility of VT
Ventricular programmed stimulation with 4 ES – complete non-inducibility of VT

Image integration-guided VT ablation studies. Adapted from Kowalewski C et al - Advanced Imaging Integration for Catheter Ablation of Ventricular Tachycardia

Publication Number of patients Age Recurrence rate Follow-up duration (months)
Njeim et al. [12] 20 59 ± 17 20% 17 ± 22
Yamashita et al. [13] 116 58 ± 15 30% 17.4
Andreu et al. [14] 54 64 ± 11 18.5% 20 ± 19
Soto-Iglesias et al. [15] 56 65 ± 12 5% 12
Berte B. et al. [16] 49 62 ± 15 27% 19 ± 8
eISSN:
2734-6382
Langue:
Anglais
Périodicité:
4 fois par an
Sujets de la revue:
Medicine, Clinical Medicine, Internal Medicine, Cardiology, Pediatrics and Juvenile Medicine, Paediatric Cardiology, Surgery, Cardiac Surgery
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