Integration of 3-dimensional scar models from SPECT to guide ventricular tachycardia ablation

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
Jing TianT Dickfeld

Abstract

The integration of myocardial scar models in 3-dimensional (3D) mapping systems may provide a novel way of helping to guide ventricular tachycardia (VT) ablations. This study assessed the value of (201)Tl SPECT perfusion imaging to define ventricular myocardial scar areas and to characterize electrophysiology voltage-derived myocardial substrate categories of scar, border zone (BZ), and normal myocardium regions. Scar and BZ regions have been implicated in the genesis of ventricular arrhythmias. Ten patients scheduled for VT ablation underwent (201)Tl SPECT before the ablation procedure. 3D left ventricular (LV) scar models were created from the SPECT images. These scar models were registered with the LV voltage maps and analyzed with a 17-segment cardiac model. Scar location and scar burden were compared between the SPECT scar models and voltage maps. In addition, (201)Tl SPECT uptake was quantified using a 68-segment cardiac model and compared among voltage-defined scar, BZ, and normal segments. 3D models of LV myocardium and scar were successfully created from (201)Tl SPECT images and integrated in a clinical mapping system. The surface registration error with the electrophysiology voltage map was 4.4 ± 1.0 mm. The 3D scar l...Continue Reading

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Citations

Nov 29, 2012·Herzschrittmachertherapie & Elektrophysiologie·Philipp HalbfassJohannes Brachmann
May 27, 2014·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Yanli ZhouJi Chen
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Jan 20, 2016·Current Cardiology Reports·John DuellTimm Dickfeld
Aug 14, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Marek SramkoKatja Zeppenfeld
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Nov 18, 2017·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Vasken Dilsizian
Jun 3, 2015·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Mohammed AbdulghaniTimm Dickfeld
Oct 28, 2019·JACC. Clinical Electrophysiology·Elad Anter

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