Purpose
Left ventricle (LV) structural changes (scar tissue and grey zones (GZ)) are the substrate for development of ventricular arrhythmias (VA).
Estimation the spatial relations between the LV structural changes and location of VA s is the aim of the study.
Methods and Materials
Study enrolled 25 patients (pts) with prior myocardial infarction(MI).
Patients underwent
- 24-hour ECG monitoring;
- body surface electroanatomical activation mapping with reconstruction of LV 3D models for location the VA origin.
On 3D models of LV electroanatomic isopotentioal and isochrone maps were reconstructed.
On theese maps the location of VA origin was detected as a point of earliest electrical activation.
- LGE MRI on 1.5 T clinical scanner using high resolution(1.25x1.25x2.5mm) inversion-recovery pulse sequence (TI 290-340ms,
TE 2,4ms,
TR 750-950ms).
On obtained images LV...
Results
The extent of scar tissue was 7.7 [4; 18.5] %.
The extent of GZ was 7.3 [5.5; 10.3] %.
The infarct zone had heterogenic structure.
The scar zone was mosaic and was surrounded by regions of GZ.
In 73% of patients (18 patients) VA origin was the zone of enhancement.
It should be mentioned that in most cases the location of VA was endocardial surface of LV (14 patients).
At the sane time some patients had epicardial origin of VA (4 patients).
No relations between...
Conclusion
A robust approach without need for special software for simultaneous assessment of left ventrical structural and electrophysiological properties is described.
In majority of patients with prior myocardial infarction ventricular arrhuthmias may originate from zones of LGE.
The data regarding the structure of the left ventricle in the planned site of ablation may improve the safety of the ablation procedure.