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Ventricular tachycardia ablation after myocardial infarction guided by cardiac magnetic resonance/multidetector computed tomography image integration Cover

Ventricular tachycardia ablation after myocardial infarction guided by cardiac magnetic resonance/multidetector computed tomography image integration

Open Access
|Mar 2024

Figures & Tables

Figure 1

12-lead ECG – Wide complex QRS tachycardia, 180/min; RBBB morphology, right-axis deviation suggestive for anterolateral LV exit-site
12-lead ECG – Wide complex QRS tachycardia, 180/min; RBBB morphology, right-axis deviation suggestive for anterolateral LV exit-site

Figure 2A

Coronary angiogram and FFR measurements – subocclusion of OM 1 (middle segment); 50 % middle LAD stenosis (FFR – 0.73); 50-60 % proximal LCx stenosis (FFR – 0.76)
Coronary angiogram and FFR measurements – subocclusion of OM 1 (middle segment); 50 % middle LAD stenosis (FFR – 0.73); 50-60 % proximal LCx stenosis (FFR – 0.76)

Figure 2B

Coronary angiogram after implantation of 3 drug-elluting stents (middle LAD, proximal LCx and middle OM1)
Coronary angiogram after implantation of 3 drug-elluting stents (middle LAD, proximal LCx and middle OM1)

Figure 3

Cardiac MRI – Mild LV dilation; LVEF – 43 %; Multiple areas of LGE along the middle third of antero-lateral and lateral wall
Cardiac MRI – Mild LV dilation; LVEF – 43 %; Multiple areas of LGE along the middle third of antero-lateral and lateral wall

Figure 4

Multimodal image integration. Right: Fusion between MDCT and LGE-CMR PSI Map (ADAS 3D Software). Left: Integration with EAM (Biosense – Webster Carto 3 Navigation System)
Multimodal image integration. Right: Fusion between MDCT and LGE-CMR PSI Map (ADAS 3D Software). Left: Integration with EAM (Biosense – Webster Carto 3 Navigation System)

Figure 5

Substrate-based RF ablation targeting conduction channels (CC) identified on fusion imaging concordant with fractionated and late potentials on EAM
Substrate-based RF ablation targeting conduction channels (CC) identified on fusion imaging concordant with fractionated and late potentials on EAM

Figure 6

EGMs before and after RF ablation showing fragmented potential abolition at the conducting channel entry
EGMs before and after RF ablation showing fragmented potential abolition at the conducting channel entry

Figure 7

Ventricular programmed stimulation with 4 ES – complete non-inducibility of VT
Ventricular programmed stimulation with 4 ES – complete non-inducibility of VT

Image integration-guided VT ablation studies_ Adapted from Kowalewski C et al - Advanced Imaging Integration for Catheter Ablation of Ventricular Tachycardia

PublicationNumber of patientsAgeRecurrence rateFollow-up duration (months)
Njeim et al. [12]2059 ± 1720%17 ± 22
Yamashita et al. [13]11658 ± 1530%17.4
Andreu et al. [14]5464 ± 1118.5%20 ± 19
Soto-Iglesias et al. [15]5665 ± 125%12
Berte B. et al. [16]4962 ± 1527%19 ± 8
DOI: https://doi.org/10.2478/rjc-2024-0004 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X
Language: English
Page range: 7 - 15
Published on: Mar 29, 2024
Published by: Romanian Society of Cardiology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2024 Alexandru – Paul Burcin, Lucian Câlmâc, Smǎrǎndiţa loana Lǎcǎu, Tudor Șarpe, Viviana Gondoș, David Sotto-Iglesias, Antonio Berruezo, Radu-Gabriel Vătășescu, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.