Simultaneous non-contact mapping fused with CMR derived grey zone to explore the relationship with ventricular tachycardia substrate in ischaemic cardiomyopathy
© Chen et al; licensee BioMed Central Ltd. 2013
Published: 30 January 2013
Cardiac magnetic resonance (CMR) imaging enables characterization of myocardial scar and the ‘grey zone', an admixture of scar and healthy myocardium, which is an independent predictor of ventricular arrhythmia. We explored the relationship between the grey zone and ventricular tachycardia circuits (VT) in ischaemic cardiomyopathy.
Sustained monomorphic VT (SMVT) was induced in both patients. Scar core and grey zone regions correlated well with the low voltage area (≤ 30% maximum voltage) seen on the MEA (Figure 1a,c,d). The exit point during SMVT from the isochrone map was located close to a channel of healthy myocardium within the grey zone (Figure 1b,d,e,f). The unipolar signals have distinct peak negative voltage in regions of scar core, grey zone and healthy myocardium (Figure 1g).
We have demonstrated that the critical substrate of re-entrant SMVT lies within the grey zone in the two ischemic cardiomyopathy study cases. CMR characterization of scar heterogeneity may provide useful information predicting the location of the critical substrate in re-entrant VT observed in patients with a previous history of myocardial infarction.
ZC and JR are joint first authors.
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