Keywords:
Ablation procedures, Image manipulation / Reconstruction, CT, Cardiac, Dysplasias
Authors:
T. Ait Ali1, H. Nivet2, M. Salel2, G. Chevreau2, O. Corneloup1, V. Latrabe1, M. Montaudon1, F. Laurent1, H. Cochet1; 1Pessac/FR, 2Bordeaux/FR
Methods and Materials
Population
We studied 16 patients with definite ARVC according to Task Force Criteria,
referred for catheter ablation of VT.
MDTC acquisition and processing
Cardiac MDCT was performed using a contrast-enhanced cardiac-gated method on a 64-slice scanner,
using a biphasic injection protocol to optimize RV chamber enhancement.
On short axis reformats,
an automatic method was applied to map any area with pixel intensity <-10HU within a 2mm-thick RV free wall layer (Figure 1).
Three-dimensional cardiac objects comprising cardiac chambers,
epicardium,
fat segmentations and coronary vessels were derived from MDCT segmentations,
and imported in 3D mapping systems to guide the ablation procedure.
Mapping and ablation
All patients underwent electroanatomical mapping.
MDCT models were registered to 3D electroanatomical geometries at the begining of the procedure.
The relationship between fat and low voltage areas was analyzed by dividing the RV free wall in 7 segments: apical,
mid (anterior,
lateral,
inferior),
and basal (anterior,
lateral,
inferior).
The location of ablation targets (local abnormal ventricular activities and critical sites of VT circuits) was analyzed with respect to fat distribution.