Arrhythmias & electrophysiologyResearch article
Computed Tomography–Derived Abrupt Wall-Thickness Transitions as Complementary Markers of Ventricular Tachycardia Substrate in Ischemic Cardiomyopathy
- Color-coded left ventricular wall-thickness maps were generated from preprocedural computed tomography angiography (CTA)
Authors' conclusion
Abrupt wall-thickness transitions on CTA-derived maps frequently colocalized with mappable VT isthmus boundaries and DZs in patients with ICM, supporting their role as complementary markers.
Study context
- Population
- Patients with ischemic cardiomyopathy (ICM) undergoing ventricular tachycardia (VT) mappingpatients with ICM (median age: 67.0 years)
- Participants
- 21 patients
- Comparison
- Abrupt wall-thickness transitions on CTA-derived maps vs deceleration zones (DZs) during baseline rhythm mapping, mappable VT isthmus boundaries, and pace map-defined exit sites in unmappable VTs
Main finding
As reported in the abstract
DZs colocalizing with abrupt wall-thickness transitions
25 DZs identified among 32 substrate maps
25
DZs colocalizing with abrupt wall-thickness transitions
92%
Further findings
Activation mapping feasibility
- Of 40 VTs, activation mapping feasible
- 20
Mappable VT isthmus boundary colocalization
- Colocalized with DZs
- 10 (50.0%)
- Colocalized with abrupt wall-thickness transitions
- 14 (70.0%)
Unmappable VTs: good pace maps consistent with VT exit sites in areas of abrupt wall-thickness transition
- Of 20 unmappable VTs
- 17 of 20 VTs (85.0%)
Segment-level positive predictive value of abrupt wall-thickness transitions
- PPV for identifying DZs
- 28.3%
- PPV for identifying VT isthmus boundaries
- 18.9%
- modest
Original publication
Computed Tomography–Derived Abrupt Wall-Thickness Transitions as Complementary Markers of Ventricular Tachycardia Substrate in Ischemic Cardiomyopathy. JACC Clin Electrophysiol. Published 7 August 2026. doi:10.1016/j.jacep.2026.07.003
Summarised from the published abstract; every number is checked against it