Regional myocardial wall thinning at multidetector computed tomography correlates to arrhythmogenic substrate in postinfarction ventricular tachycardia: assessment of structural and electrical substrate - Inria - Institut national de recherche en sciences et technologies du numérique Access content directly
Journal Articles Circulation. Arrhythmia and electrophysiology Year : 2013

Regional myocardial wall thinning at multidetector computed tomography correlates to arrhythmogenic substrate in postinfarction ventricular tachycardia: assessment of structural and electrical substrate

Yuki Komatsu
  • Function : Author
Amir Jadidi
  • Function : Author
Frédéric Sacher
  • Function : Author
Ashok Shah
  • Function : Author
Nicolas Derval
  • Function : Author
Daniel Scherr
  • Function : Author
Patrizio Pascale
  • Function : Author
Laurent Roten
  • Function : Author
Arnaud Denis
  • Function : Author
Khaled Ramoul
  • Function : Author
Shinsuke Miyazaki
  • Function : Author
Matthew Daly
  • Function : Author
Jatin Relan
  • Function : Author
  • PersonId : 761727
  • IdRef : 167644211
Mélèze Hocini
  • Function : Author
Michel Haïssaguerre
  • Function : Author
Pierre Jaïs
  • Function : Author

Abstract

A majority of patients undergoing ablation of ventricular tachycardia have implanted devices precluding substrate imaging with delayed-enhancement MRI. Contrast-enhanced multidetector computed tomography (MDCT) can depict myocardial wall thickness with submillimetric resolution. We evaluated the relationship between regional myocardial wall thinning (WT) imaged by MDCT and arrhythmogenic substrate in postinfarction ventricular tachycardia.We studied 13 consecutive postinfarction patients undergoing MDCT before ablation. MDCT data were integrated with high-density 3-dimensional electroanatomic maps acquired during sinus rhythm (endocardium, 509±291 points/map; epicardium, 716±323 points/map). Low-voltage areas (100 ms after QRS complex) were almost exclusively detected within the thinnest area (93% in the WT<3 mm).Regional myocardial WT correlates to low-voltage regions and distribution of LAVA critical for the generation and maintenance of postinfarction ventricular tachycardia. The integration of MDCT WT with 3-dimensional electroanatomic maps can help focus mapping and ablation on the culprit regions, even when MRI is precluded by the presence of implanted devices.

Dates and versions

hal-00855932 , version 1 (30-08-2013)

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Yuki Komatsu, Hubert Cochet, Amir Jadidi, Frédéric Sacher, Ashok Shah, et al.. Regional myocardial wall thinning at multidetector computed tomography correlates to arrhythmogenic substrate in postinfarction ventricular tachycardia: assessment of structural and electrical substrate. Circulation. Arrhythmia and electrophysiology, 2013, 6 (2), pp.342-350. ⟨10.1161/CIRCEP.112.000191⟩. ⟨hal-00855932⟩

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