Arrhythmias & electrophysiology
Post-Ablation cardiac Magnetic resonance to assess Ventricular Tachycardia recurrence (PAM-VT study)
An erratum to this article was published (Eur Heart J Cardiovasc Imaging, 29 Jan 2024 ↗)
Authors' conclusion
Post-ablation LGE-CMR is feasible, and a reduction in the number of CCs is related with lower risk of VT recurrence. The dark core was not present in all patients. A decrease in VT substrate was also observed in patients without a dark core area in the post-ablation LGE-CMR.
Study context
- Population
- Consecutive patients referred for scar-related ventricular tachycardia (VT) ablation61 underwent ablation
- Participants
- 49 patients
- Exposure
- Post-ablation vs pre-ablation late gadolinium enhancement cardiac magnetic resonance (LGE-CMR)
- Outcome
- Ability of post-ablation LGE-CMR to evaluate ablation lesions (scar characteristics, conducting channels)
Methodological detailsconsecutive patients, March 2019-April 2021
- Consecutive patients
- March 2019-April 2021
Main finding
As reported in the abstract
| Group | Number of conducting channels (CCs) | Mass of CCs |
|---|---|---|
| Pre-ablation | 3.34 ± 1.03 | 8.45 ± 1.3 g |
| Post-ablation | 1.6 ± 0.2 | 3.5 ± 0.6 g |
Number of conducting channels (CCs)
Pre-ablation3.34 ± 1.03
Post-ablation1.6 ± 0.2
Mass of CCs
Pre-ablation8.45 ± 1.3 g
Post-ablation3.5 ± 0.6 g
- Post-ablation vs Pre-ablation: P < 0.0001 — number of CCs decreased
- Post-ablation vs Pre-ablation: P < 0.001 — mass of CCs decreased
- Arrhythmogenic CCs disappeared
- 74.4%
Observational data: associations, not effects.
Further findings
| Outcome | Values | P value |
|---|---|---|
| ≥2 channels on post-ablation LGE-CMR as predictor of VT recurrence≥2 channels vs <2 channels | ≥2 channels 31.82% · sensitivity 100% · specificity 61% · AUC 0.82 · <2 channels 0% | P = 0.0038 |
| CC reduction <55% to predict VT recurrence | CC reduction <55% sensitivity 100% · specificity 61% · AUC 0.83 |
Dark core on post-ablation LGE-CMR
- Dark core detected
- 75.5%
- Dark core not related to CC reduction (52.2 ± 7.4% vs. 40.8 ± 10.6%)
- P = 0.57
VT recurrence · one year
- VT recurrence
- 16.3%
Original publication
Post-Ablation cardiac Magnetic resonance to assess Ventricular Tachycardia recurrence (PAM-VT study). Eur Heart J Cardiovasc Imaging. Published 11 October 2023. doi:10.
Summarised from the published abstract; every number is checked against it