Andrea Romagnoli MD, Abstract Co-Author: Nothing to Disclose

Massimiliano Sperandio MD, Abstract Co-Author: Nothing to Disclose

Chiara Arganini MD, Presenter: Nothing to Disclose

Eleonora Gaspari, Abstract Co-Author: Nothing to Disclose

Maria Chiara Petrella, Abstract Co-Author: Nothing to Disclose

Giovanni Simonetti MD, Abstract Co-Author: Nothing to Disclose

The aim of our study is to evaluate the accuracy of 64-slice CT to detect the geometry of the myocardial infarction scar, using 2D and 3D reconstructions. Its use in ablation procedures may facilitate the electrophysiological procedures providing preliminary indication to guide mapping. 

32 patients (mean age 61±15.4) underwent 64-slice CT heart examination. These patients, affected by monomorphic ventricular tachycardia late after myocardial infarction, were waiting for a heart ablation. All the patients had a ICD (Implanted Cardiac Defibrillator). We compared the obtained data from CT with the results of electrophysiological mapping study CARTO, to evaluate the concordance between the two techniques.

CT permitted the correct highlighting of the post-infarction scar as a myocardial hypoattenuation area (mean 56.53 ± 19.3 vs. 131.4 ± 20.5 HU; P< 0.0001)in all the patients. The mean wall thickness in diastole of the infarcted regions was 4.3 ± 1.11 mm against mean wall thickness in the healthy areas of 8.24 ± 1.3 (P< 0.0001). Mean wall thickness in systole (normality range 12-14 mm) was 6.23 mm ± 1.46(P< 0.0001).Comparing CT data with the result of CARTO, using potential values of <1.5 mV as cut off, we observed that the areas of morph structural alteration (reductions in thickness and density) predicted the low voltage areas in 28 of the 32 patients.

Initial results indicate that CT could help the ablation procedure. Infact, accurately predicting the localization of the scar and its extension, electrophysiological mapping studies can be directly concentrated in the zone of the scar and the surrounding area, therefore allowing a drastic reduction of the duration of the procedure and of the complications.

64-slice CT could be a valid alternative to the MR studies in the planning of treatment of ventricular tachycardia that require ablation.

Romagnoli, A, Sperandio, M, Arganini, C, Gaspari, E, Petrella, M, Simonetti, G, Usefulness of 64-slice CT in the Planning of Ablation of Ventricular Tachycardia Late after Myocardial Infarction.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8008980.html