Are wall thickness channels defined by computed tomography predictive of isthmuses of postinfarction ventricular tachycardia? - Inria - Institut national de recherche en sciences et technologies du numérique Access content directly
Journal Articles Heart Rhythm Year : 2019

Are wall thickness channels defined by computed tomography predictive of isthmuses of postinfarction ventricular tachycardia?

Josselin Duchateau
  • Function : Author
Frederic Sacher
  • Function : Author
Konstantinos Vlachos
  • Function : Author
Nathaniel Thompson
  • Function : Author
Calire Martin
  • Function : Author
Grégoire Massoullié
  • Function : Author
Felix Bourier
  • Function : Author
Anna Lam
  • Function : Author
Michael Wolf
  • Function : Author
William Escande
  • Function : Author
Clémentine André
  • Function : Author
Thomas Pambrun
  • Function : Author
Arnaud Denis
  • Function : Author
Hubert Cochet
  • Function : Author
  • PersonId : 880054
Pierre Jaïs
  • Function : Author

Abstract

ObjectiveThis study sought to determine whether 3-dimensionally-reconstructed computed tomography (CT) channels correlate with electrophysiological isthmuses during ventricular tachycardia (VT).MethodsWe retrospectively studied 9 postinfarction patients (aged 57 ± 15 years, 1 female) with 10 complete VT activation maps (cycle length 429 ± 77ms) created using high-resolution mapping. Three-dimensionally-reconstructed WT maps from CT were merged with the activation map during sinus rhythm (SR) and VT. The relationship between WT and electrophysiological characteristics was analyzed.ResultsA total of 41 CT channels were identified (median 4 per patient), of median (range) length 21.2 mm (17.3–36.8 mm), width 9.0 mm (6.7–16.5 mm), and area 1.49 cm2(1.00–1.75 cm2). WT in the channel was significantly thicker in the center than in the edge (median 2.4 mm vs 1.5 mm, P < .0001). Of 3163 (2493–5960) mapping points in SR, 382 (191–1115) local abnormal ventricular activities (LAVAs) were identified. One patient had a maximal proportion of LAVAs in 3–4 mm, 3 patients in 2–3 mm, 2 in 1–2 mm, and 2 in 0–1 mm. The VT isthmuses of all 10 VTs corresponded with 1–4 CT channels. Twenty-one of the 41 CT channels (51.2%) corresponded to a VT isthmus (entrance, mid, or exit). Electrophysiological VT isthmuses were more likely to be associated with CT channels that were longer (P = .04, odds ratio [OR] 1.05/mm), thinner (but not less than 1 mm) (P = .03, OR 0.36/mm), or parallel to the mitral annulus (P = .07, OR 3.93).ConclusionVT isthmuses were always found in CT channels (100% sensitivity), and half of CT channels hosted VT isthmuses (PPV 51%). Longer and thinner (but >1 mm) CT channels were significantly associated with VT isthmuses.
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hal-02181776 , version 1 (20-07-2022)

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Masateru Takigawa, Josselin Duchateau, Frederic Sacher, Ruairidh Martin, Konstantinos Vlachos, et al.. Are wall thickness channels defined by computed tomography predictive of isthmuses of postinfarction ventricular tachycardia?. Heart Rhythm, 2019, Heart Rhythm, 16 (11), pp.1661-1668. ⟨10.1016/j.hrthm.2019.06.012⟩. ⟨hal-02181776⟩
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