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Updated: Jan 17, 2026
Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
Ventricular tachycardia substrate mapping with cardiac computed tomography and cardiac magnetic resonance imaging:
Damian Laan1, Luuk H G A Hopman1, Rosa M Figueras I Ventura2
1Department of Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Background:
Advanced postprocessing of late gadolinium enhancement cardiac magnetic resonance (CMR) and computed tomography (CCT) imaging increasingly guides ventricular tachycardia ablation. However, a direct comparison between 2 widely adopted platforms, ADAS 3D LV (Adas3D Medical) and inHEART (IHU Liryc/Inria), is lacking.
Objective:
This study aimed to compare CMR- and CCT-derived ventricular substrate models generated by ADAS 3D and inHEART in patients with ischemic and nonischemic cardiomyopathy undergoing ventricular tachycardia ablation.
Methods:
Patients who underwent both CCT and late gadolinium enhancement CMR before ablation were retrospectively included. ADAS 3D models were generated on-site, whereas inHEART models were processed remotely. Substrate models were evaluated using a custom scoring system incorporating quantitative (scar mass, transmurality) and qualitative parameters (wall thickness, scar delineation, and conduction corridors). Electroanatomic maps (EAMs) assessed correspondence between low-voltage and ablation regions, with imaging-defined corridors.
Results:
16 patients (n = 8 ischemic, n = 8 nonischemic) were analyzed; 12 had detailed EAM data. Scar core and border zone measurements were comparable between platforms in both subgroups (all P > .05). ADAS 3D showed slightly higher visualization scores, particularly in nonischemic cardiomyopathy, although differences were not statistically significant. Spatial concordance between imaging-derived scar and EAM-defined ablation areas was good to excellent in 10 of 12 cases.
Conclusion:
ADAS 3D and inHEART demonstrated high concordance in scar quantification and substrate characterization, with comparable performance across cardiomyopathy types. Given their complementary strengths, platform choice should be guided by procedural goals, imaging availability, operator experience, and institutional context, as each system offers distinct advantages. Prospective studies are needed to evaluate the impact on procedural success and long-term outcomes.
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