000165358 001__ 165358
000165358 005__ 20260107201858.0
000165358 0247_ $$2doi$$a10.1016/j.jacep.2019.11.004
000165358 0248_ $$2sideral$$a146809
000165358 037__ $$aART-2020-146809
000165358 041__ $$aeng
000165358 100__ $$aSoto-Iglesias D
000165358 245__ $$aCardiac Magnetic Resonance-Guided Ventricular Tachycardia Substrate Ablation.
000165358 260__ $$c2020
000165358 5060_ $$aAccess copy available to the general public$$fUnrestricted
000165358 5203_ $$aObjectives
This study assessed the feasibility and potential benefit of performing ventricular tachycardia (VT) substrate ablation procedures guided by cardiac magnetic resonance (CMR)-derived pixel signal intensity (PSI) maps.
Background
CMR-aided VT ablation using PSI maps from late gadolinium enhancement-CMR (LGE-CMR), together with electroanatomical map (EAM) information, has been shown to improve outcomes of VT substrate ablation.
Methods
Eighty-four patients with scar-dependent monomorphic VT who underwent substrate ablation were included in the study. In the last 28 (33%) consecutive patients, the procedure was guided by CMR. Procedural data, as well as acute and follow-up outcomes, were compared between patients who underwent guided CMR and 2 control groups: 1) patients who had PSI maps were available but the EAM was acquired and used to select the ablation targets (CMR aided); and 2) patients with no CMR-derived PSI maps available (no CMR).
Results
Mean procedure duration was lower in CMR-guided substrate ablation compared with CMR-aided and no CMR (107 ± 59 min vs. 203 ± 68 min and 227 ± 52 min; p < 0.001 for both comparisons). CMR-guided ablation required less fluoroscopy time than CMR-aided ablation and no CMR (10 ± 4 min vs. 23 ± 11 min and 20 ± 9 min, respectively; p < 0.001 for both comparisons) and less radiofrequency time (15 ± 8 min vs. 20 ± 15 min and 26 ± 10 min; p = 0.16 and p < 0.001, respectively). After substrate ablation, VT inducibility was lower in CMR-guided ablation compared with CMR-aided ablation and no CMR (18% vs. 32% and 46%; p = 0.35 and p = 0.04, respectively), without significant differences in complications. After 12 months, VT recurrence was lower in those who underwent CMR-guided ablation compared with no CMR (log-rank: 0.019), with no differences with CMR-aided ablation.
Conclusions
CMR-guided VT ablation is feasible and safe, significantly reduces the procedural, fluoroscopy, and radiofrequency times, and is associated with a higher noninducibility rate and lower VT recurrence after substrate ablation.
000165358 536__ $$9info:eu-repo/grantAgreement/ES/MINECO/RTC-2015-3515-1$$9info:eu-repo/grantAgreement/ES/MINECO/RTC-2016-5445-1
000165358 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
000165358 590__ $$a6.375$$b2020
000165358 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b26 / 141 = 0.184$$c2020$$dQ1$$eT1
000165358 592__ $$a2.278$$b2020
000165358 593__ $$aPhysiology (medical)$$c2020$$dQ1
000165358 593__ $$aCardiology and Cardiovascular Medicine$$c2020$$dQ1
000165358 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000165358 700__ $$aPenela D
000165358 700__ $$0(orcid)0000-0001-9187-1773$$aJáuregui B
000165358 700__ $$aAcosta J
000165358 700__ $$aFernández-Armenta J
000165358 700__ $$aLinhart M
000165358 700__ $$aZucchelli G
000165358 700__ $$aSyrovnev V
000165358 700__ $$aZaraket F
000165358 700__ $$aTerés C
000165358 700__ $$aPerea RJ
000165358 700__ $$aPrat-González S
000165358 700__ $$aDoltra A
000165358 700__ $$aOrtiz-Pérez JT
000165358 700__ $$aBosch X
000165358 700__ $$aCamara O
000165358 700__ $$aBerruezo A
000165358 773__ $$g6, 4 (2020), 436 - 447$$tJACC: Clinical Electrophysiology$$x2405-500X
000165358 8564_ $$s12084788$$uhttps://zaguan.unizar.es/record/165358/files/texto_completo.pdf$$yPostprint
000165358 8564_ $$s2000597$$uhttps://zaguan.unizar.es/record/165358/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000165358 909CO $$ooai:zaguan.unizar.es:165358$$particulos$$pdriver
000165358 951__ $$a2026-01-07-18:53:05
000165358 980__ $$aARTICLE