Key result
CMR detects scar in 100% of DCM and ICM patients, often nontransmural at VT exit sites.
Why the study?
The relationship between the occurrence of ventricular tachycardia and the characteristics of scar tissue detected by contrast-enhanced magnetic resonance imaging has not been fully studied.
Does contrast-enhanced magnetic resonance imaging (CMR) predict the VT exit site in patients with monomorphic sustained VT and structural heart disease?
Observational (n=34)
Does contrast-enhanced magnetic resonance imaging (CMR) predict the VT exit site in patients with monomorphic sustained VT and structural heart disease?
Contrast-enhanced MRI can identify nontransmural scar tissue, which frequently correlates with the VT exit site in patients with structural heart disease, potentially aiding in ablation planning.
CMR scar features may associate with VT in DCM/ICM; leaves open whether imaging refines ablation targeting.
BACKGROUND: Contrast-enhanced magnetic resonance imaging (CMR) identifies scar tissue as an area of delayed enhancement (DE). The scar region might be the substrate for ventricular tachycardia (VT). However, the relationship between the occurrence of VT and the characteristics of scar tissue has not been fully studied. METHODS: CMR was performed in 34 patients with monomorphic, sustained VT and dilated cardiomyopathy (DCM, n = 18), ischemic cardiomyopathy (ICM, n = 10), or idiopathic VT (IVT, n = 6). The VT exit site was assessed by a detailed analysis of the QRS morphology, including bundle branch block type, limb lead polarity, and precordial R-wave transition. On CMR imaging, the transmural score of each of the 17 segments was assigned, using a computer-assisted, semiautomatic technique, to measure the DE areas. Segmental scars were classified as nontransmural when DE was 1-75% and transmural when DE was 76-100% of the left ventricular mass in each segment. RESULTS: A scar was detected in all patients with DCM or ICM. Nontransmural scar tissue was often found at the VT exit site, in patients with DCM or ICM. In contrast, no scar was found in patients with IVT. CONCLUSIONS: CMR clarified the characteristics and distribution of scar tissue in patients with structural heart disease, and the presence and location of scar tissue might predict the VT exit site in these patients.
No takes yet. Share an insight, caveat, or question.
Yokokawa et al. (2009) conducted an observational in Monomorphic, sustained ventricular tachycardia (n=34). Contrast-enhanced magnetic resonance imaging (CMR) was evaluated on Presence and characteristics of scar tissue at the ventricular tachycardia exit site. Contrast-enhanced magnetic resonance imaging detected scar tissue in 100% of patients with DCM (n=18) or ICM (n=10), with nontransmural scar tissue often found at the VT exit site.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: