Arrhythmias & electrophysiology
Intracardiac Echocardiography for the Detection of Arrhythmogenic Periaortic Ventricular Tachycardia Substrate: Multimodality Core Lab Analysis
Authors' conclusion
ICE-detected wall thinning may be a novel imaging technique to identify arrhythmogenic periaortic VT substrate in this challenging anatomic region, which often eludes diagnosis with CMR. The absence of LGE on CMR does not rule out the presence of periaortic substrate in patients presenting with outflow tract VT.
Study context
- Population
- Ventricular tachycardia (VT) ablation patients with structural heart disease, categorized periaortic arrhythmogenic substrate (PAS)+ or PAS- by voltage-defined scar and deceleration zonesPAS+ 29, PAS- 55
- Participants
- 84 patients
- Comparison
- Intracardiac echocardiography (ICE) wall thickness vs CMR-LGE for detecting periaortic arrhythmogenic substrate
- Outcome
- Diagnostic performance for PAS+ (sensitivity, specificity, PPV, NPV)
Methodological detailsindependent core lab
- Independent core lab
Performance
As reported in the abstract
Detection of PAS+
| Test or model | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
| ICE | 58% | 87% | 71% | 80% |
| CMR-LGE | 50% | 84% | 69% | 70% |
Sensitivity
ICE58%
CMR-LGE50%
Specificity
ICE87%
CMR-LGE84%
PPV
ICE71%
CMR-LGE69%
NPV
ICE80%
CMR-LGE70%
Further findings
ICE wall thickness at 1 cm from LV ostium
P < 0.001
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Intracardiac Echocardiography for the Detection of Arrhythmogenic Periaortic Ventricular Tachycardia Substrate: Multimodality Core Lab Analysis. JACC Clin Electrophysiol. Published 17 September 2025. doi:10.
Summarised from the published abstract; every number is checked against it