Head-to-Head Comparison of T1 Mapping and Electroanatomical Voltage Mapping in Patients With Ventricular Arrhythmias

Šramko, Marek; Abdel-Kafi, Saif; Wijnmaalen, Adrianus P.; Tao, Qian; Geest, Rob J. van der; Lamb, Hildo J.; Zeppenfeld, Katja

doi:10.1016/j.jacep.2022.10.035

Cited by 2 publications

(1 citation statement)

References 19 publications

(23 reference statements)

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“…The clinical value of these techniques in the setting of EP interventions requires further studies. 22 , 23 …”

Section: Basic Concepts Of Computed Tomography and Magnetic Resonance...mentioning

confidence: 99%

Pre- and post-procedural cardiac imaging (computed tomography and magnetic resonance imaging) in electrophysiology: a clinical consensus statement of the European Heart Rhythm Association and European Association of Cardiovascular Imaging of the European Society of Cardiology

Deneke,

Kutyifa,

Hindricks

et al. 2024

Europace

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Imaging using cardiac computed tomography (CT) or magnetic resonance imaging (MR) has become an important option for anatomic and substrate delineation in complex atrial and ventricular tachycardia (VT) ablation procedures. CT more common than MR has been used to detect procedure-associated complications like esophageal, cerebral and vascular injury. This clinical consensus statement summarizes the current knowledge of CT and MR to facilitate electrophysiological procedures, the current value of real-time integration of imaging-derived anatomy and substrate information during the procedure and the current role of CT and MR in diagnosing relevant procedure-related complications. Practical advice on potential advantages of one imaging modality over the other is discussed for patients with implanted cardiac rhythm devices as well as for planning, intraprocedural integration and post-interventional management in atrial fibrillation (AF) and VT ablation patients. Establishing a team of electrophysiologists and cardiac-imaging specialists working on specific details of imaging for complex ablation procedures is key. CMR can safely be performed in most patients with implanted active cardiac devices. Standard procedures for pre- and post-scanning management of the device and potential CMR-associated device-malfunctions need to be in place. In VT patients imaging - specifically MR - may help to determine scar location and mural distribution in ischemic and non-ischemic cardiomyopathy patients beyond evaluating the underlying structural heart disease. Future directions in imaging may include the ability to register multiple imaging modalities, novel high-resolution modalities but also refinements of imaging-guided ablation strategies are expected.

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“…The clinical value of these techniques in the setting of EP interventions requires further studies. 22 , 23 …”

Section: Basic Concepts Of Computed Tomography and Magnetic Resonance...mentioning

confidence: 99%

Pre- and post-procedural cardiac imaging (computed tomography and magnetic resonance imaging) in electrophysiology: a clinical consensus statement of the European Heart Rhythm Association and European Association of Cardiovascular Imaging of the European Society of Cardiology

Deneke,

Kutyifa,

Hindricks

et al. 2024

Europace

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Area-weighted unipolar voltage to predict heart failure outcomes in patients with ischaemic cardiomyopathy and ventricular tachycardia

Rademaker,

Kimura,

de Riva Silva

et al. 2024

Europace

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Aims Patients with ischaemic cardiomyopathy (ICM) referred for catheter ablation of ventricular tachycardia (VT) are at risk for end-stage heart failure (HF) due to adverse remodelling. Local unipolar voltages (UV) decrease with loss of viable myocardium. A UV parameter reflecting global viable myocardium may predict prognosis. We evaluate if a newly proposed parameter, area-weighted unipolar voltage (awUV), can predict HF-related outcomes [HFO; HF death/left ventricular (LV) assist device/heart transplant] in ICM. Methods and results From endocardial voltage maps of consecutive patients with ICM referred for VT ablation, awUV was calculated by weighted interpolation of local UV. Associations between clinical and mapping parameters and HFO were evaluated and validated in a second cohort. The derivation cohort consisted of 90 patients [age 68 ±8 years; LV ejection fraction (LVEF) 35% interquartile range (IQR) (24–40)] and validation cohort of 60 patients [age 67 ± 9, LVEF 39% IQR (29–45)]. In the derivation cohort, during a median follow-up of 45 months [IQR (34–83)], 36 (43%) patients died and 23 (26%) had HFO. Patients with HFO had lower awUV [4.51 IQR (3.69–5.31) vs. 7.03 IQR (6.08–9.2), P < 0.001]. A reduction in awUV [optimal awUV (5.58) cut-off determined by receiver operating characteristics analysis] was a strong predictor of HFO (3-year HFO survival 97% vs. 57%). The cut-off value was confirmed in the validation cohort (2-year HFO-free survival 96% vs. 60%). Conclusion The newly proposed parameter awUV, easily available from routine voltage mapping, may be useful at identifying ICM patients at high risk for HFO.

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Head-to-Head Comparison of T1 Mapping and Electroanatomical Voltage Mapping in Patients With Ventricular Arrhythmias

Cited by 2 publications

References 19 publications

Pre- and post-procedural cardiac imaging (computed tomography and magnetic resonance imaging) in electrophysiology: a clinical consensus statement of the European Heart Rhythm Association and European Association of Cardiovascular Imaging of the European Society of Cardiology

Pre- and post-procedural cardiac imaging (computed tomography and magnetic resonance imaging) in electrophysiology: a clinical consensus statement of the European Heart Rhythm Association and European Association of Cardiovascular Imaging of the European Society of Cardiology

Area-weighted unipolar voltage to predict heart failure outcomes in patients with ischaemic cardiomyopathy and ventricular tachycardia

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