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A. Basics
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
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23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
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26. Cardiovascular Surgery
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Correlation between left ventricle wall-thickness by CT and endocardial potentials in patients with ischemic cardiopathy– a pilot study
Session:
Posters (Sessão 2 - Écran 2) - Arritmias 2 - Arritmias Ventriculares 1
Speaker:
Gonçalo José Lopes Da Cunha
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme:
08.4 Ventricular Arrhythmias and SCD - Treatment
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Gonçalo Lopes da Cunha; Sérgio Maltês; Pedro Freitas; Sara Guerreiro; João Abecasis; Gustavo Rodrigues; João Carmo; Pedro Galvão Santos; Francisco Costa; Pedro Carmo; Diogo Cavaco; Francisco Morgado; Miguel Mendes; António Ferreira; Pedro Adragão
Abstract
<p>Introduction<br /> Scar-related ventricular tachycardia (VT) is frequently the treatment target in patients with ischemic cardiopathy undergoing VT ablation. While cardiac magnetic resonance (CMR) is the gold standard for planning VT ablation, its accuracy is hindered in patients with implanted cardiac defibrillators (ICD) and resynchronization therapy (CRT). Cardiac computed tomography (CT) has emerged as an alternative for ablation planning in these patients.<br /> The purpose of this study was to evaluate the relationship between wall thickness (WT) on cardiac CT and intensity of electrical potentials on endocardial eletroanatomic mapping (EAM) in patients with ischemic cardiopathy.</p> <p><br /> Methods<br /> This was a single centre retrospective study enrolling patients with ischemic cardiopathy referred for endocardial VT ablation that underwent cardiac CT for procedure planning. Patients were excluded if EAM had <1000 data points. ADAS 3D® software was used to analyse CT images, automatically segmenting the left ventricle (LV) into the 17 American Heart Association segments and calculating end-diastolic WT for each one. Screenshots of the segmented LV on ADAS were taken in 4 standardized planes (antero-posterior, postero-anterior, superior and inferior) and used to aid in manual segmentation of EAM. The endocardial voltage maps were created using CARTO3® (Biosense Webster). For each patient, EAM was interpreted to create 2 bulls ‘eye maps, according to the presence or absence of bipolar potentials <0.5 (dense scar) or 1.5mV (low voltage). Only segments that had >20% extension of low bipolar voltage were considered as altered. </p> <p>Results<br /> We included a cohort of 5 patients with a median age of 69 (68-71) years, all male with a median LVEF of 35% (28-35)). All but one patient had implanted cardiac device (3 ICD, 1 CRT-D). CT was performed a mean of 1.3 days before the ablation. We analysed 85 segments, 4 of which did not have voltage information. Of the remaining 81, 37 (44%) had dense scar and 45 (53%) had low voltage. There was a good correlation between mean WT and the presence or absence of both dense scar (area under de curve (AUC) 0.808, p<0.001) and low voltage (AUC 0.796, p<0.001) in each LV segment.</p> <p>Conclusion<br /> WT measured by CT seems to have a strong correlation with dense scar and low voltage in EAM in patients with previous myocardial infarction undergoing VT ablation. This technique may be useful to plan interventions in patients in whom CMR is not feasible.</p>
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