Arrhythmia substrate identification using wideband motion-corrected late gadolinium enhancement magnetic resonance imaging in a swine model of myocardial infarction with taped implantable cardioverter-defibrillators

IF 2.9 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Rhythm O2 Pub Date : 2025-09-01 DOI:10.1016/j.hroo.2025.06.008

Calder D. Sheagren PhD , Terenz Escartin MSc , Jaykumar H. Patel BSc , Jennifer Barry BSc , Kelvin Chow PhD , Xiaoming Bi PhD , Maria Terricabras MD, MSc , Graham A. Wright PhD

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Abstract

Background

Sudden cardiac death is a leading worldwide cause of cardiac mortality and is largely related to ventricular tachycardia (VT) in patients with known myocardial scarring. In these patients, implantable cardioverter-defibrillator (ICD) therapy reduces arrhythmia-related mortality. However, curative procedures such as catheter ablation are used to homogenize regions of scar and remove structural re-entry circuits that cause VT.

Objective

In this paper, we conduct a preliminary experiment comparing 2-dimensional (2D) late gadolinium enhancement (LGE) and 3-dimensional (3D) LGE without an ICD with wideband motion-corrected (WB-MOCO) LGE with an ICD in a cohort of infarcted Yorkshire swine.

Methods

Animals were imaged after infarct with conventional 2D and 3D LGE without an ICD present and 2D WB-MOCO LGE with an ICD present. Images were analyzed to determine heterogeneous tissue corridor (HTC) count and location, which were compared with circuit exit locations determined using a 12-lead electrocardiogram.

Results

We found a statistically significant increase in HTC count with WB-MOCO LGE, but no significant differences in the number of true-positive or false-positive HTCs per subject.

Conclusion

WB-MOCO LGE has reduced specificity to physiologically relevant HTCs than conventional 2D or 3D LGE.

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在带带植入式心律转复除颤器的猪心肌梗死模型中，使用宽带运动校正晚期钆增强磁共振成像识别心律失常底物

背景：心源性猝死是世界范围内心脏性死亡的主要原因，在很大程度上与已知心肌瘢痕患者的室性心动过速（VT）有关。在这些患者中，植入式心律转复除颤器（ICD）治疗可降低心律失常相关的死亡率。然而，治疗性手术（如导管消融）被用于均匀化疤痕区域并去除导致vtt的结构再入回路。目的在本文中，我们在梗死约克郡猪队列中进行了初步实验，比较二维（2D）晚期钆增强（LGE）和三维（3D）无ICD LGE以及宽带运动校正（WB-MOCO） LGE和ICD。方法对梗死后动物进行常规二维、三维LGE和二维WB-MOCO LGE成像，观察有无ICD。分析图像以确定异质组织走廊（HTC）的计数和位置，并将其与使用12导联心电图确定的电路出口位置进行比较。结果我们发现，WB-MOCO LGE组HTC计数有统计学意义的增加，但每个受试者的真阳性和假阳性HTC数量无统计学意义的差异。结论与传统的2D或3D LGE相比，wb - moco LGE对生理相关HTCs的特异性降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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