Response by Zghaib et al to Letter Regarding Article, “Standard Ablation Versus Magnetic Resonance Imaging–Guided Ablation in the Treatment of Ventricular Tachycardia”

Zghaib, Tarek; İpek, Esra Gücük; Hansford, Rozann; Ashikaga, Hiroshi; Berger, Ronald D.; Marine, Joseph E.; Spragg, David D.; Tandri, Harikrishna; Zimmerman, Stefan L.; Halperin, Henry R.; Brancato, Scott; Calkins, Hugh; Henrikson, Charles A.; Nazarian, Saman

doi:10.1161/circep.118.006413

Cited by 3 publications

(2 citation statements)

References 10 publications

(8 reference statements)

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“…In recent years, a number of observational studies have shown how peri-procedural CMR imaging may allow targeting the arrhythmogenic substrate of VAs, possibly improving ablation success and ultimately reducing mortality ( 35 , 36 ).…”

Section: Ventricular Arrhythmiasmentioning

confidence: 99%

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Multi-Modality Imaging for the Identification of Arrhythmogenic Substrates Prior to Electrophysiology Studies

Gimelli

Ernst

Liga

2021

Front. Cardiovasc. Med.

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Noninvasive cardiac imaging is crucial for the characterization of patients who are candidates for cardiac ablations, for both procedure planning and long-term management. Multimodality cardiac imaging can provide not only anatomical parameters but even more importantly functional information that may allow a better risk stratification of cardiac patients. Moreover, fusion of anatomical and functional data derived from noninvasive cardiac imaging with the results of endocavitary mapping may possibly allow a better identification of the ablation substrate and also avoid peri-procedural complications. As a result, imaging-guided electrophysiological procedures are associated with an improved outcome than traditional ablation procedures, with a consistently lower recurrence rate.

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Section: Ventricular Arrhythmiasmentioning

confidence: 99%

“…The area of necrosis identified by CMR correlates well with areas of low voltage revealed by EAM ( 6 , 37 – 39 ). Hence, the three-dimensional (3D) integration of these two techniques seems instrumental for a better identification of the anatomical substrates on where to concentrate ablations ( 35 , 36 ).…”

Section: Ventricular Arrhythmiasmentioning

confidence: 99%

Multi-Modality Imaging for the Identification of Arrhythmogenic Substrates Prior to Electrophysiology Studies

Gimelli

Ernst

Liga

2021

Front. Cardiovasc. Med.

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Advancement in cardiac imaging for treatment of ventricular arrhythmias in structural heart disease

et al. 2018

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Over the last decades, substrate-based approaches to ventricular tachycardia (VT) ablation have evolved into an important therapeutic option for patients with various structural heart diseases (SHD) and unmappable VT. The well-recognized limitations of conventional electroanatomical mapping (EAM) to delineate the complex 3D architecture of scar, and the potential capability of advanced cardiac imaging technologies to provide adjunctive information, have stimulated electrophysiologists to evaluate the role of imaging to improve safety and efficacy of catheter ablation. In this review, we summarize the histological differences between SHD aetiologies related to monomorphic sustained VT and the currently available data on the histological validation of cardiac imaging modalities and EAM to delineate scar and the arrhythmogenic substrate. We review the current evidence of the value provided by cardiac imaging to facilitate VT ablation and to ultimately improve outcome.

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Is it feasible to offer ‘targeted ablation’ of ventricular tachycardia circuits with better understanding of isthmus anatomy and conduction characteristics?

Bourier

Martin

et al. 2019

EP Europace

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Abstract Successful mapping and ablation of ventricular tachycardias remains a challenging clinical task. Whereas conventional entrainment and activation mapping was for many years the gold standard to identify reentrant circuits in ischaemic ventricular tachycardia ablation procedures, substrate mapping has become the cornerstone of ventricular tachycardia ablation. In the last decade, technology has dramatically improved. In parallel to high-density automated mapping, cardiac imaging and image integration tools are increasingly used to assess the structural ventricular tachycardia substrate. The aim of this review is to describe the technologies underlying these new mapping systems and to discuss their possible role in providing new insights into identification and visualization of reentrant tachycardia mechanisms.

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Response by Zghaib et al to Letter Regarding Article, “Standard Ablation Versus Magnetic Resonance Imaging–Guided Ablation in the Treatment of Ventricular Tachycardia”

Cited by 3 publications

References 10 publications

Multi-Modality Imaging for the Identification of Arrhythmogenic Substrates Prior to Electrophysiology Studies

Multi-Modality Imaging for the Identification of Arrhythmogenic Substrates Prior to Electrophysiology Studies

Advancement in cardiac imaging for treatment of ventricular arrhythmias in structural heart disease

Is it feasible to offer ‘targeted ablation’ of ventricular tachycardia circuits with better understanding of isthmus anatomy and conduction characteristics?

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