Integration of merged delayed-enhanced magnetic resonance imaging and multidetector computed tomography for the guidance of ventricular tachycardia ablation: a pilot study.

Détails

Ressource 1Télécharger: BIB_C8962560AF81.P001.pdf (939.61 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_C8962560AF81
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Integration of merged delayed-enhanced magnetic resonance imaging and multidetector computed tomography for the guidance of ventricular tachycardia ablation: a pilot study.
Périodique
Journal of Cardiovascular Electrophysiology
Auteur(s)
Cochet H., Komatsu Y., Sacher F., Jadidi A.S., Scherr D., Riffaud M., Derval N., Shah A., Roten L., Pascale P., Relan J., Sermesant M., Ayache N., Montaudon M., Laurent F., Hocini M., Haïssaguerre M., Jaïs P.
ISSN
1540-8167 (Electronic)
ISSN-L
1045-3873
Statut éditorial
Publié
Date de publication
2013
Volume
24
Numéro
4
Pages
419-426
Langue
anglais
Notes
Publication types: Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Résumé
BACKGROUND: Delayed enhancement (DE) MRI can assess the fibrotic substrate of scar-related VT. MDCT has the advantage of inframillimetric spatial resolution and better 3D reconstructions. We sought to evaluate the feasibility and usefulness of integrating merged MDCT/MRI data in 3D-mapping systems for structure-function assessment and multimodal guidance of VT mapping and ablation.
METHODS: Nine patients, including 3 ischemic cardiomyopathy (ICM), 3 nonischemic cardiomyopathy (NICM), 2 myocarditis, and 1 redo procedure for idiopathic VT, underwent MRI and MDCT before VT ablation. Merged MRI/MDCT data were integrated in 3D-mapping systems and registered to high-density endocardial and epicardial maps. Low-voltage areas (<1.5 mV) and local abnormal ventricular activities (LAVA) during sinus rhythm were correlated to DE at MRI, and wall-thinning (WT) at MDCT.
RESULTS: Endocardium and epicardium were mapped with 391 ± 388 and 1098 ± 734 points per map, respectively. Registration of MDCT allowed visualization of coronary arteries during epicardial mapping/ablation. In the idiopathic patient, integration of MRI data identified previously ablated regions. In ICM patients, both DE at MRI and WT at MDCT matched areas of low voltage (overlap 94 ± 6% and 79 ± 5%, respectively). In NICM patients, wall-thinning areas matched areas of low voltage (overlap 63 ± 21%). In patients with myocarditis, subepicardial DE matched areas of epicardial low voltage (overlap 92 ± 12%). A total number of 266 LAVA sites were found in 7/9 patients. All LAVA sites were associated to structural substrate at imaging (90% inside, 100% within 18 mm).
CONCLUSION: The integration of merged MDCT and DEMRI data is feasible and allows combining substrate assessment with high-spatial resolution to better define structure-function relationship in scar-related VT.
Mots-clé
Adult, Catheter Ablation/methods, Cicatrix/complications, Cicatrix/pathology, Contrast Media/diagnostic use, Coronary Angiography/methods, Electrophysiologic Techniques, Cardiac, Feasibility Studies, Female, Fibrosis, Heart Ventricles/pathology, Heart Ventricles/physiopathology, Heterocyclic Compounds/diagnostic use, Humans, Imaging, Three-Dimensional, Iopamidol/analogs & derivatives, Iopamidol/diagnostic use, Magnetic Resonance Imaging, Male, Middle Aged, Multidetector Computed Tomography, Organometallic Compounds/diagnostic use, Pilot Projects, Predictive Value of Tests, Prospective Studies, Radiographic Image Interpretation, Computer-Assisted, Tachycardia, Ventricular/etiology, Tachycardia, Ventricular/pathology, Tachycardia, Ventricular/</QualifierName> <QualifierName MajorTopicYN="Y">, Therapy, Computer-Assisted, Treatment Outcome
Pubmed
Web of science
Création de la notice
14/07/2014 16:57
Dernière modification de la notice
03/03/2018 21:21
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