Arrhythmias & electrophysiology
Heart Digital Twins Predict Features of Invasive Reentrant Circuits and Ablation Lesions in Scar-Dependent Ventricular Tachycardia
Authors' conclusion
Heart digital twin VT circuits and ablation targets accurately predict many features of their respective clinical counterparts but have some limitations in spatial resolution. Our findings demonstrate the significant potential of digital twin technology in guiding catheter ablation for scar-dependent VT.
Study context
- Population
- Patients with scar-dependent ventricular tachycardia (VT) undergoing digital twin creation based on preprocedural, contrast-enhanced cardiac magnetic resonance imaging and subsequent invasive VT ablationpatients with scar-dependent VT
- Participants
- 18 patients
- Comparison
- Digital twin-predicted VT circuits and ablation lesions were compared with their invasive clinical counterparts
- Outcome
- VTs induced
Main finding
As reported in the abstract
Invasive clinical
43
events
Digital twin
92
events
Further findings
| Outcome | Digital twin | Invasive clinical | |
|---|---|---|---|
| Detection of critical VT sites by digital twins | |||
| Sensitivity | 81.3% | Not reported in the abstract | Invasive clinical: not reported in the abstract |
| Specificity | 83.8% | Not reported in the abstract | Invasive clinical: not reported in the abstract |
| Positive predictive value | 21.7% | Not reported in the abstract | Invasive clinical: not reported in the abstract |
| Negative predictive value | 98.8% | Not reported in the abstract | Invasive clinical: not reported in the abstract |
Diastolic activity in clinical VTs
- Diastolic activity seen in clinical VTs
- 16 of 43 (37.2%)
Agreement between clinical VT critical sites and digital twin primary predicted sites at American Heart Association-segment level
- κ coefficient (moderate agreement)
- 0.46 (±0.32; P ≤0.001)
Termination of VT with ablation at a digital twin-predicted site
- Cases where attempted
- 4 of 5 (80%)
Lesions within 5 mm of a predicted target site
- Lesions within 5 mm
- 426 of 709 (60.1%)
Digital twin-predicted area ablated per patient based on conventional mapping criteria
- Area ablated
- 54.0% (±28.9%)
Original publication
Summarised from the published abstract; every number is checked against it