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Initial experience on cardiac magnetic resonance-aided VT ablation in South America

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Abstract

Background

Cardiac magnetic resonance (CMR) allowed to precisely identify the substrate in scar-related ventricular tachycardia (VT). New software has been developed to define the 3D scar and corridors to help VT ablation by integrating the scar and electroanatomical mapping (EAM). The objective of this study is to evaluate the results of VT ablation aided by the integration of EAM and CMR software processed scar.

Methods

We selected patients that underwent VT ablation with the integration of EAM and CMR processed using ADAS software and imported to the CARTO system using VTK file format.

Results

From 2019 to 2021, eight patients (mean age 63 ± 4.4, 62.5% male; EF 47 ± 12%) underwent CMR-aided VT ablation. Mean procedural time was 281 ± 77 min. There was of 9 ± 4.4 epicardial and 7.9 ± 4.3 endocardial bulls eye segments with at least 2 g of border zone or core scar. In a median follow-up time of 532 days (Q1: 284, Q3: 688), three patients (37.5%) presented VT recurrence, all three underwent a second procedure, with no VT recurrence on the follow-up. No patient died in the follow-up.

Conclusion

CMR aided is ablation is feasible and effective in patients with scar related VT.

Graphical Abstract

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Data availability

The datasets analyzed in this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Arrhythmia Unit, InCor – Heart Institute – University of São Paulo Medical School, Av Dr Eneas Carvalho de Aguiar, 44, São Paulo, SP, CEP 05403-000, Brazil

    Cristiano F. Pisani, Felipe Kalil Alexandre, Rodrigo Kulchetscki, Marina Mayrink, Tan Chen Wu, Muhieddine Chokr, Carina Hardy, Sissy Lara Melo & Mauricio Scanavacca

  2. Magnetic Resonance and Tomography Unit InCor, University of São Paulo Medical School, São Paulo, Brazil

    Carlos Rochitte & Cesar Nomura

Authors
  1. Cristiano F. Pisani
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  2. Felipe Kalil Alexandre
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  3. Rodrigo Kulchetscki
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  4. Marina Mayrink
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  5. Tan Chen Wu
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  6. Muhieddine Chokr
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  7. Carina Hardy
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  8. Sissy Lara Melo
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  9. Carlos Rochitte
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  10. Cesar Nomura
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  11. Mauricio Scanavacca
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Corresponding author

Correspondence to Cristiano F. Pisani.

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Ethics approval

This is a retrospective data collection of procedures performed in our institution.

Informed consent

Patients consented with the procedure and data collection.

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The authors declare no conflict of interest.

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Supplementary Information

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Supplementary file1 (MP4 25095 kb) Video: CMR aided VT ablation in a patient with mitral valve repair and infero-basal scar. Ablation targeted the scar and corridor detected on CMR reconstructed using ADAS

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Pisani, C.F., Alexandre, F.K., Kulchetscki, R. et al. Initial experience on cardiac magnetic resonance-aided VT ablation in South America. J Interv Card Electrophysiol 66, 1581–1587 (2023). https://doi.org/10.1007/s10840-022-01464-x

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  • DOI: https://doi.org/10.1007/s10840-022-01464-x

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