Abstract
Background Ventricular tachycardia (VT) ablation is generally guided by invasive mapping of the left ventricle (LV) using electro-anatomical voltage mapping (EAM) to identify the VT substrate [1]. Late gadolinium enhancement (LGE) MRI allows excellent visualization of the scar. Heterogeneous area in LGE images has been shown to correlate with the VT substrate in animal models of VT. Retrospective studies in patients have also correlated the LGE signal enhancement to low voltage in EAM maps. However, current clinical EAM platform such as the Carto3 (Biosense Webster) does not allow integration of LGE images for facilitating the VT ablation. In this study, we described a workflow to integrate scar geometry extracted from highresolution 3D LGE images with EAM.
Highlights
Ventricular tachycardia (VT) ablation is generally guided by invasive mapping of the left ventricle (LV) using electro-anatomical voltage mapping (EAM) to identify the VT substrate [1]
The transmural intensity is extracted for each endocardial mesh point and can be used to measure spatial characteristics of the scar such as the scar thickness or the scar transmurality level
The scar spatial characteristic of each endocardial mesh point is color coded and the overall endocardial mesh is saved into the VTK format (Kitware Inc)
Summary
Ventricular tachycardia (VT) ablation is generally guided by invasive mapping of the left ventricle (LV) using electro-anatomical voltage mapping (EAM) to identify the VT substrate [1]. Late gadolinium enhancement (LGE) MRI allows excellent visualization of the scar. Heterogeneous area in LGE images has been shown to correlate with the VT substrate in animal models of VT. Retrospective studies in patients have correlated the LGE signal enhancement to low voltage in EAM maps. Current clinical EAM platform such as the Carto (Biosense Webster) does not allow integration of LGE images for facilitating the VT ablation. We described a workflow to integrate scar geometry extracted from highresolution 3D LGE images with EAM
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