Arrhythmias & electrophysiology

Arrhythmogenic vulnerability of re-entrant pathways in post-infarct ventricular tachycardia assessed by advanced computational modelling

EuropacePublished Retrospective computational modelling study

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
Methodological detailssimulation (Virtual Induction and Treatment of Arrhythmias (VITA) framework)
  • Simulation (VITA framework)

Main finding

As reported in the abstract

Total and unique simulated VTs
GroupTotal VTsUnique VTs
Recurrence85 ± 439 ± 4
No recurrence42 ± 275 ± 4

Total VTs

Recurrence85 ± 43
No recurrence42 ± 27

Unique VTs

Recurrence9 ± 4
No recurrence5 ± 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

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