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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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VT ablation based on CT imaging substrate visualization: results from a large cohort of ischemic and non-ischemic

F Englert1, F Bahlke1, N Erhard1

  • 1Department of Electrophysiology, German Heart Center Munich, Technical University of Munich (TUM), Lazarettstr. 36, 80636, Munich, Germany.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|December 19, 2023
PubMed

Insights

inHEART-guided ventricular tachycardia (VT) ablation shows reduced recurrence compared to traditional methods. This advanced imaging approach may improve outcomes, especially for ischemic cardiomyopathies.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Ventricular tachycardia (VT) ablation aims to eliminate isthmus sites.
  • High-resolution CT imaging and 3D cardiac models (inHEART) aid VT ablation planning.
  • Limited data exist comparing inHEART-assisted VT ablation with traditional methods.

Purpose of the Study:

  • To compare the outcomes of VT ablations using inHEART-guided procedures versus conventional approaches.
  • To evaluate the efficacy of inHEART in reducing VT recurrence.

Main Methods:

  • Retrospective analysis of 108 patients undergoing VT ablation.
  • One cohort used inHEART with late-enhancement CT; the other used conventional substrate and activation mapping.
  • Ablations performed with a 3D mapping system (Carto3) and PENTARAY™ NAV catheter, integrated with inHEART models when available.

Main Results:

  • The inHEART group demonstrated a trend towards lower VT recurrence (27% vs. 42%, p<0.06).
  • Patients with ischemic cardiomyopathies showed a significantly higher success rate with inHEART-assisted ablation (p=0.05).

Conclusions:

  • inHEART-guided VT ablation is associated with reduced VT recurrence compared to conventional procedures.
  • Advanced imaging and computational modeling, like inHEART, show promise in improving VT ablation outcomes.
  • inHEART may be particularly beneficial for patients with ischemic cardiomyopathies.
Abstract

Keywords:
CardiomyopathyLate enhancementVT ablationWall thinninginHEART

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