Arrhythmias & electrophysiologyCohort study
Arrhythmogenic vulnerability of re-entrant pathways in post-infarct ventricular tachycardia assessed by advanced computational modelling
- Retrospective computational modelling study
- simulation (Virtual Induction and Treatment of Arrhythmias (VITA) framework)
Authors' conclusion
Advanced computational metrics can non-invasively and robustly assess VT substrate complexity, which may aid personalized clinical planning and decision-making in the treatment of post-infarction VT.
Study context
- Population
- Post-infarct ventricular tachycardia (VT)-ablation patients with 2D-LGE images
- Participants
- 20 patients
- Exposure
- Patients with vs without VT recurrence
- Outcome
- Simulation metrics of substrate complexity (total and unique VTs) vs VT recurrence
- Follow-up
- follow-up
Main finding
As reported in the abstract
Total and unique simulated VTs
| Group | Total VTs | Unique VTs |
|---|---|---|
| Recurrence | 85 ± 43 | 9 ± 4 |
| No recurrence | 42 ± 27 | 5 ± 4 |
- AUC for recurrence, total VTs
- 0.820
- AUC for recurrence, unique VTs
- 0.770
Observational data: associations, not effects.
Further findings
Robustness to scar threshold (pixel-signal-intensity (PSI) 40-60, 45-55, 35-65, 30-70)
- No significant impact on total and unique VTs and mean round-trip-time (RTT) between the four models
- PSI 45-55 model had the most parameters predictive of post-ablation VT recurrence
Original publication
Arrhythmogenic vulnerability of re-entrant pathways in post-infarct ventricular tachycardia assessed by advanced computational modelling. Europace. Published 8 July 2023. doi:10.1093/europace/euad198
Summarised from the published abstract; every number is checked against it