Key result
Intracardiac echocardiography identified ventricular tachycardia scar substrate, with significantly higher signal intensity units in scar tissue (89.9) compared to healthy myocardium (56.9).
Why the study?
It was unclear whether signal intensity units on intracardiac echocardiography could identify left ventricular scar tissue to guide catheter ablation of substrate-based ventricular tachycardia.
Does intracardiac echocardiography (ICE) signal intensity accurately identify left ventricular scar substrate compared to electroanatomic mapping and CE-CMR in patients undergoing VT ablation?
Observational (n=12)
No
Does intracardiac echocardiography (ICE) signal intensity accurately identify left ventricular scar substrate compared to electroanatomic mapping and CE-CMR in patients undergoing VT ablation?
Absolute Event Rate: 89.9% vs 56.9%
p-value: p=0.001
Intracardiac echocardiography signal intensity units can accurately identify left ventricular scar substrate, corresponding well with electroanatomic mapping and CE-CMR, and may be useful for guiding VT ablation.
We assessed whether signal intensity units (SIUs) on intracardiac echocardiography (ICE) images can be used to identify scar tissue in the left ventricle (LV) and, thus, guide ablation of substrate-based ventricular tachycardia. Two-dimensional ICE images were obtained from 12 patients undergoing catheter ablation and were used for 3D reconstruction of the LV. Electroanatomic maps were also obtained. Contrast-enhanced cardiac magnetic resonance imaging (CE-CMR) was performed in 8 of these patients. The SIUs for the ICE images, low-voltage zones on the electroanatomic maps, and late gadolinium-enhancement areas on the CE-CMR images corresponded. Thus, ICE may be useful for identifying LV scar substrate.
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Takahashi et al. (2018) conducted an observational in Recurrent drug-refractory ventricular tachycardia (n=12). Intracardiac echocardiography (ICE) vs. Normal myocardium was evaluated on Signal intensity units (SIUs) of scar tissue versus healthy myocardium (p=0.001). Intracardiac echocardiography identified ventricular tachycardia scar substrate, with significantly higher signal intensity units in scar tissue (89.9) compared to healthy myocardium (56.9).
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