Integration of 3D nuclear imaging in 3D mapping system for ventricular tachycardia ablation in patients with implanted devices : Perfusion/voltage retrospective assessment of scar location
© 2022 Heart Rhythm Society. Published by Elsevier Inc..
Background: The identification of low-voltage proarrhythmic areas for catheter ablation of scar-mediated ventricular tachycardia (VT) remains challenging. Integration of myocardial perfusion imaging (single-photon emission computed tomography/computed tomography; SPECT/CT) and electroanatomical mapping (EAM) may improve delineation of the arrhythmogenic substrate.
Objective: To assess the feasibility of SPECT/CT image integration with voltage maps using the EnSite Precision system (Abbott) in patients undergoing scar-mediated VT ablation.
Methods: Patients underwent SPECT/CT imaging prior to left ventricular (LV) EAM with the EnSite Precision mapping system. The SPECT/CT, EAM data, and ablation lesions were retrospectively co-registered in the EnSite Precision system and exported for analysis. Segmental tissue viability scores were calculated based on SPECT/CT perfusion and electrogram bipolar voltage amplitude. Concordance, specificity, and sensitivity between the 2 modalities as well as the impact of SPECT/CT spatial resolution were evaluated.
Results: Twenty subjects (95% male, 67 ± 7 years old, left ventricular ejection fraction 36% ± 11%) underwent EAM and SPECT/CT integration. A concordance of 70% was found between EAM and SPECT/CT for identification of cardiac segments as scar vs viable, with EAM showing a 68.5% sensitivity and 76.4% specificity when using SPECT/CT as a gold standard. Projection on low-resolution 3D geometries led to an average decrease of 38% ± 22% of the voltage points used.
Conclusion: The study demonstrated the feasibility of integrating SPECT/CT with EAM performed retrospectively for characterization of anatomical substrates during VT ablation procedures.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:3 |
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| Enthalten in: |
Heart rhythm O2 - 3(2022), 5 vom: 28. Okt., Seite 560-567 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Thibault, Bernard [VerfasserIn] |
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| Links: |
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| Themen: |
Implanted device |
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| Anmerkungen: |
Date Revised 08.11.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.hroo.2022.06.008 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM348543409 |
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| 100 | 1 | |a Thibault, Bernard |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Integration of 3D nuclear imaging in 3D mapping system for ventricular tachycardia ablation in patients with implanted devices |b Perfusion/voltage retrospective assessment of scar location |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 08.11.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2022 Heart Rhythm Society. Published by Elsevier Inc. | ||
| 520 | |a Background: The identification of low-voltage proarrhythmic areas for catheter ablation of scar-mediated ventricular tachycardia (VT) remains challenging. Integration of myocardial perfusion imaging (single-photon emission computed tomography/computed tomography; SPECT/CT) and electroanatomical mapping (EAM) may improve delineation of the arrhythmogenic substrate | ||
| 520 | |a Objective: To assess the feasibility of SPECT/CT image integration with voltage maps using the EnSite Precision system (Abbott) in patients undergoing scar-mediated VT ablation | ||
| 520 | |a Methods: Patients underwent SPECT/CT imaging prior to left ventricular (LV) EAM with the EnSite Precision mapping system. The SPECT/CT, EAM data, and ablation lesions were retrospectively co-registered in the EnSite Precision system and exported for analysis. Segmental tissue viability scores were calculated based on SPECT/CT perfusion and electrogram bipolar voltage amplitude. Concordance, specificity, and sensitivity between the 2 modalities as well as the impact of SPECT/CT spatial resolution were evaluated | ||
| 520 | |a Results: Twenty subjects (95% male, 67 ± 7 years old, left ventricular ejection fraction 36% ± 11%) underwent EAM and SPECT/CT integration. A concordance of 70% was found between EAM and SPECT/CT for identification of cardiac segments as scar vs viable, with EAM showing a 68.5% sensitivity and 76.4% specificity when using SPECT/CT as a gold standard. Projection on low-resolution 3D geometries led to an average decrease of 38% ± 22% of the voltage points used | ||
| 520 | |a Conclusion: The study demonstrated the feasibility of integrating SPECT/CT with EAM performed retrospectively for characterization of anatomical substrates during VT ablation procedures | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Implanted device | |
| 650 | 4 | |a Ischemic scar | |
| 650 | 4 | |a Perfusion imaging | |
| 650 | 4 | |a SPECT/CT | |
| 650 | 4 | |a Ventricular ischemia | |
| 650 | 4 | |a Ventricular tachycardia | |
| 650 | 4 | |a Voltage mapping | |
| 700 | 1 | |a Richer, Louis-Philippe |e verfasserin |4 aut | |
| 700 | 1 | |a McSpadden, Luke C |e verfasserin |4 aut | |
| 700 | 1 | |a Ryu, Kyungmoo |e verfasserin |4 aut | |
| 700 | 1 | |a Aguilar, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Cadrin-Tourigny, Julia |e verfasserin |4 aut | |
| 700 | 1 | |a Tadros, Rafik |e verfasserin |4 aut | |
| 700 | 1 | |a Mondésert, Blandine |e verfasserin |4 aut | |
| 700 | 1 | |a Rivard, Léna |e verfasserin |4 aut | |
| 700 | 1 | |a Dyrda, Katia |e verfasserin |4 aut | |
| 700 | 1 | |a Dubuc, Marc |e verfasserin |4 aut | |
| 700 | 1 | |a Macle, Laurent |e verfasserin |4 aut | |
| 700 | 1 | |a Talajic, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Khairy, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Guerra, Peter G |e verfasserin |4 aut | |
| 700 | 1 | |a Roy, Denis |e verfasserin |4 aut | |
| 700 | 1 | |a Grégoire, Jean |e verfasserin |4 aut | |
| 700 | 1 | |a Harel, François |e verfasserin |4 aut | |
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