Arrhythmias & electrophysiology
Ring-Like Scar Architecture and Arrhythmic Outcomes of Patients With Nondilated Left Ventricular Cardiomyopathy Treated With Ventricular Tachycardia Ablation
Authors' conclusion
RL-LGE identifies patients with NDLVC with a more complex arrhythmogenic substrate and a poorer outcome after VT ablation.
Study context
- Population
- Patients with nondilated left ventricular cardiomyopathy (NDLVC) undergoing ventricular tachycardia (VT) ablationpatients included
- Participants
- Thirty-seven patients
- Comparison
- Patients with ring-like late gadolinium enhancement (RL-LGE) compared with patients without it
- RL-LGEn = 21
- Outcome
- Left ventricular ejection fraction
Methodological detailssingle centre (Hospital Clínic of Barcelona), postprocessed cardiac magnetic resonance
- Single centre (Hospital Clínic of Barcelona)
- Postprocessed cardiac magnetic resonance
Main finding
As reported in the abstract
P < 0.0001
Further findings
Length of conducting channels · longer with RL-LGE
P < 0.0001
| Outcome | Estimate | P value | |
|---|---|---|---|
| Predictors of VT recurrenceDense scar | HR 1.13 per 1% increment (95% CI 1.05–1.22) | P = 0.002 | |
| Predictors of VT recurrenceLength of conducting channels | HR 1.04 per 1 mm increase (95% CI 1.01–1.06) | P = 0.006 | |
| 0.512Hazard ratio (log scale) |
Predictors of VT recurrence
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Borderzone scar burden | 1.27 (1.11–1.45) | P = 0.001 | |
| Number of conducting channels | 2.35 (1.42–3.91) | P = 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Adjusted risk of VT recurrence
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| RL-LGE24-fold higher in patients with RL-LGE; adjusted | 24.0 (2.8–207.1) | P = 0.004 | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | RL-LGE | Without RL-LGE | P value |
|---|---|---|---|
| Scar burdenGreater with RL-LGE | 16.2% (range 12.7%–20.0%) | 5.4% (range 5.0%–6.0%) | P < 0.0001 |
| Number of arrhythmogenic conducting channelsLarger with RL-LGE | 3 (range 2–4) | 1 (range 1–2) | P < 0.0001 |
VT recurrence · median of 3 years of follow-up
- Patients with VT recurrence
- 30%
- Event rate
- 10.2%/year
Baseline characteristics
- Age
- 44 years [IQR: 39-55]
- Male
- 78%
- Left ventricular ejection fraction
- 45% [IQR: 40-52]
- RL-LGE observed
- 21 of 37 (57%)
Original publication
Ring-Like Scar Architecture and Arrhythmic Outcomes of Patients With Nondilated Left Ventricular Cardiomyopathy Treated With Ventricular Tachycardia Ablation. JACC Clin Electrophysiol. Published 8 September 2026. doi:10.
Summarised from the published abstract; every number is checked against it