Arrhythmias & electrophysiologyResearch article
Impact of Congenital Substrate 3D Imaging Reconstruction to Guide Ventricular Tachycardia (VT) Catheter Ablation: The CORECA Study
- Consecutive patients with cardiac computed tomography or magnetic resonance imaging referred for VT ablation in 5 congenital electrophysiology centers
- observers blinded to the ablation procedure and each other
Authors' conclusion
In our series, 3-dimensional anatomic reconstruction enabled identification of the critical VT substrate in most patients with complex congenital heart disease, particularly those with anatomically based reentrant circuits. Substrate target can be identified by operators with good interobserver reproducibility. This approach may guide VT ablation in these challenging cases.
Study context
- Population
- Patients with congenital heart disease and VT referred for catheter ablation with preprocedural cardiac computed tomography or magnetic resonance imagingpatients who underwent VT ablation, including 28 with a history of spontaneous sustained VT
- Participants
- Forty patients
- Comparison
- Preprocedural 3-dimensional imaging reconstruction annotations compared between observers and with ablation target(s) on electroanatomical mapping
Main finding
As reported in the abstract
VT inducible
97.5%
Further findings
Acute success rate of ablation
- Acute success rate
- 92.5%
Concordance of imaging-identified VT substrate with electroanatomical mapping
- Concordant cases
- 87.5%
Positive interobserver agreement
- Complete
- 65.0%
- Moderate
- 22.5%
- Poor
- 5.0%
- High degree of agreement between the observers
Isthmus identification by imaging vs electroanatomical mapping
- Sensitivity
- 87.0%
- Positive predictive value
- 77.0%
Original publication
Summarised from the published abstract; every number is checked against it