Abstract
Background The mechanisms involved in the sustenance of scarrelated ventricular fibrillation (VF) are poorly understood. Recent developments in body surface potential mapping (BSM) now enable non-invasive, real-time and wholeheart assessment of cardiac activation during VF. We sought to analyze the relationships between focal/reentrant activities during VF and scar characteristics on late gadonlinium-enhanced (LGE) CMR in patients with ischemic VF. Methods 7 patients with history of prior myocardial infarction who presented a VF episode underwent CMR prior to ICD implantation. LGE imaging was performed on a 1.5T system (Avanto, Siemens Medical Solutions, Erlangen, Germany) 15 min after the injection of 0.2 mmol/Kg gadoterate meglumine, using an inversion recovery-prepared and respiratory navigated 3D Turbo FLASH sequence with fat saturation, in order to acquire a whole heart volume at high spatial resolution (pixel size 1.25 × 1.25
Highlights
The mechanisms involved in the sustenance of scarrelated ventricular fibrillation (VF) are poorly understood
Reentrant regions clustered to scar borders, with a distance to scar in regions with vs without reentry of +3.6 [-7.1 - +20.0] vs +28.2 [+6.9 - +50.5] mm, p < 0.0001
Post-infarction VF is driven by a combination of reentrant and focal sources
Summary
Post-infarction ventricular fibrillation mechanisms: Insights from combined body surface potential mapping and late gadolinium-enhanced CMR. Hubert Cochet*, Stephanie Clement-Guinaudeau, Marjorie Salel, Olivier Corneloup, Michel Montaudon, François Laurent. From 19th Annual SCMR Scientific Sessions Los Angeles, CA, USA. From 19th Annual SCMR Scientific Sessions Los Angeles, CA, USA. 27-30 January 2016
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