Ventricular Tachycardia Substrate Mapping with Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging: Head-to-head Comparison of Two Clinically Available Post-processing Platforms.
Damian Laan, Luuk H G A Hopman, Rosa M Figueras I Ventura, Bruno Soré, Cornelis P Allaart, Michiel J B Kemme, Marco Götte, Pieter G Postema, Pranav Bhagirath
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引用次数: 0
Abstract
Background: Advanced postprocessing of late-gadolinium enhanced cardiac magnetic resonance (LGE-CMR) and computed tomography (CCT) imaging increasingly guides ventricular tachycardia (VT) ablation. However, a direct comparison between two widely adopted platforms, ADAS 3D LV (ADAS3D Medical) and inHEART (IHU LIRYC/Inria), is lacking.
Objective: To compare CMR- and CCT-derived ventricular substrate models generated by ADAS 3D and inHEART in patients with ischemic and non-ischemic cardiomyopathy undergoing VT ablation.
Methods: Patients who underwent both CCT and LGE-CMR prior to ablation were retrospectively included. ADAS 3D models were generated on-site, while inHEART models were processed remotely. Substrate models were evalauted using a custom scoring system incorporating quantitative (scar mass, transmurality) and qualitative (wall thickness, scar delineation, conduction corridors) parameters. Electroanatomical maps (EAM) assessed correspondence between low-voltage and ablation regions, with imaging-defined corridors.
Results: Sixteen patients (n=8 ischemic, n=8 non-ischemic) were analysed, 12 had detailed EAM data. Scar core and border zone measurements were comparable between platforms in both subgroups (all p>0.05). ADAS 3D showed slightly higher visualization scores, particularly in non-ischemic cardiomyopathy, though differences were not statistically significant. Spatial concordance between imaging-derived scar and EAM-defined ablation areas was good to excellent in 10 of 12 cases.
Conclusion: ADAS 3D and inHEART demonstrated high concordance in scar quantification and substrate characterization, with comparable performance across cardiomyopathy types. Given their complementary strengths, platform choice should be guided by procedural goals, imaging availability, operator experience, and institutional context, as each system offers distinct advantages. Prospective studies are needed to evaluate impact on procedural success and long-term outcomes.
期刊介绍：
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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