Arrhythmias & electrophysiology
Predicting postinfarct ventricular tachycardia by integrating cardiac MRI and advanced computational reentrant pathway analysis
Authors' conclusion
A detailed quantitative analysis of LGE-based scar maps, combined with advanced computational modeling, can accurately predict ICD therapy
Study context
- Population
- Patients with MI who underwent late gadolinium enhancement (LGE) imaging before implantable cardiac defibrillator (ICD) implantation17 with an event
- Participants
- 40 patients
- Exposure
- LGE CMR scar metrics and Virtual Induction and Treatment of Arrhythmias (VITA) computational modelling vs appropriate ICD therapy during follow-up
- Outcome
- Appropriate ICD therapy (event) during follow-up
Methodological detailsPatient-specific 3D ventricular models (ADAS 3D LV and custom software); VITA framework probed scar substrate vulnerability to reentry
- Patient-specific 3D ventricular models (ADAS 3D LV and custom software); VITA framework probed scar substrate vulnerability to reentry
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
Interfacehealthy myocardium–scar interface
2.79(1.44–5.44)
P < 0.01Unique ventricular tachycardiasVITA metric
1.67(1.04–2.68)
P = 0.03Mean RTTVITA metric
2.14(1.11–4.12)
P = 0.02Maximum RTTVITA metric
2.13(1.19–3.81)
P = 0.01Observational data: associations, not effects.
Original publication
Predicting postinfarct ventricular tachycardia by integrating cardiac MRI and advanced computational reentrant pathway analysis. Heart Rhythm. Published 24 April 2024. doi:10.
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