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- Title
Post-Ablation cardiac Magnetic resonance to assess Ventricular Tachycardia recurrence (PAM-VT study).
- Authors
Roca-Luque, Ivo; Vázquez-Calvo, Sara; Garre, Paz; Ortiz-Perez, Jose T; Prat-Gonzalez, Susanna; Sanchez-Somonte, Paula; Ferro, Elisenda; Quinto, Levio; Alarcón, Francisco; Althoff, Till; Perea, Rosario Jesús; Ventura, Rosa M Figueras i; Guasch, Eduard; Tolosana, José Maria; Lorenzatti, Daniel; Morr-Verenzuela, Carlos Igor; Porta-Sanchez, Andreu; Arbelo, Elena; Sitges, Marta; Brugada, Josep
- Abstract
Aims Conducting channels (CCs) detected by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) are related to ventricular tachycardia (VT). The aim of this work was to study the ability of post-ablation LGE-CMR to evaluate ablation lesions. Methods and results This is a prospective study of consecutive patients referred for a scar-related VT ablation. LGE-CMR was performed 6–12 months prior to ablation and 3–6 months after ablation. Scar characteristics of pre- and post-ablation LGE-CMR were compared. During the study period (March 2019−April 2021), 61 consecutive patients underwent scar-related VT ablation after LGE-CMR. Overall, 12 patients were excluded (4 had poor-quality LGE-CMR, 2 died before post-ablation LGE-CMR, and 6 underwent post-ablation LGE-CMR 12 months after ablation). Finally, 49 patients (age: 65.5 ± 9.8 years, 97.9% male, left ventricular ejection fraction: 34.8 ± 10.4%, 87.7% ischaemic cardiomyopathy) were included. Post-ablation LGE-CMR showed a decrease in the number (3.34 ± 1.03 vs. 1.6 ± 0.2; P < 0.0001) and mass (8.45 ± 1.3 vs. 3.5 ± 0.6 g; P < 0.001) of CCs. Arrhythmogenic CCs disappeared in 74.4% of patients. Dark core was detected in 75.5% of patients, and its presence was not related to CC reduction (52.2 ± 7.4% vs. 40.8 ± 10.6%, P = 0.57). VT recurrence after one year follow-up was 16.3%. The presence of two or more channels in the post-ablation LGE-CMR was a predictor of VT recurrence (31.82% vs. 0%, P = 0.0038) with a sensibility of 100% and specificity of 61% (area under the curve 0.82). In the same line, a reduction of CCs < 55% had sensibility of 100% and specificity of 61% (area under the curve 0.83) to predict VT recurrence. Conclusion Post-ablation LGE-CMR is feasible, and a reduction in the number of CCs is related with lower risk of VT recurrence. The dark core was not present in all patients. A decrease in VT substrate was also observed in patients without a dark core area in the post-ablation LGE-CMR.
- Subjects
VENTRICULAR ejection fraction; RADIO frequency therapy; CATHETER ablation; MAGNETIC resonance imaging; VENTRICULAR tachycardia; DISEASE relapse; DESCRIPTIVE statistics; RESEARCH funding; SENSITIVITY &; specificity (Statistics); LONGITUDINAL method; HEART conduction system; HEART diseases
- Publication
European Heart Journal - Cardiovascular Imaging, 2024, Vol 25, Issue 2, p188
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jead261