Arrhythmias & electrophysiology
Image Integration to Identify Histologic and Electroanatomic Ventricular Scar: A Clinicopathological Study Comparing 2 Image Integration Systems
Authors' conclusion
ADAS-3D and inHEART image integration provide similar characterization of scar distribution and allowed similar display of the anatomic relation of critical re-entry circuit sites detected by mapping to scar. However, limitations exist in the performance of these technologies to identify epicardial and noncompact scar.
Study context
- Population
- Sheep with anteroseptal infarction undergoing electroanatomic mapping; human subjects with ventricular tachycardia (VT) (postinfarction or nonischemic cardiomyopathy)Five sheep · 5 human subjects · sheep Five · human subjects 5
- Comparison
- Cardiac magnetic resonance (CMR) segmented by ADAS-3D and inHEART validated with histology for 3 layers (the endocardium, intramural layer, and epicardium)
- Outcome
- Accuracy to identify endocardial and intramural scar vs whole-heart histology
Methodological detailsco-registered histological data, subsequent clinical validation study
- Co-registered histological data
- Subsequent clinical validation study
Performance
As reported in the abstract
Comparable accuracy with moderate agreement
>75%
Further findings
Accuracy in the epicardial layers
- Modest accuracy and fair agreement
- 60%-68%
Identification of noncompact scar
- Both technologies performed poorly
Colocalization of critical sites of VT with ADAS-3D and inHEART scar
- Falling within 1 scar layer
- 88%
VT critical sites with CMR late gadolinium enhancement scar in more than 1 layer
- VT critical sites
- More than 80%
Original publication
Image Integration to Identify Histologic and Electroanatomic Ventricular Scar: A Clinicopathological Study Comparing 2 Image Integration Systems. JACC Clin Electrophysiol. Published 8 January 2026. doi:10.
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