Ventricular tachycardia substrate mapping with cardiac computed tomography and cardiac magnetic resonance imaging: Head-to-head comparison of two clinically available postprocessing platforms.
Damian Laan, Luuk H G A Hopman, Rosa M Figueras I Ventura, Bruno Soré, Cornelis P Allaart, Michiel J B Kemme, Marco J W Götte, Pieter G Postema, Pranav Bhagirath
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引用次数: 0
Abstract
Background: Advanced postprocessing of late gadolinium enhancement cardiac magnetic resonance (CMR) and computed tomography (CCT) imaging increasingly guides ventricular tachycardia ablation. However, a direct comparison between 2 widely adopted platforms, ADAS 3D LV (Adas3D Medical) and inHEART (IHU Liryc/Inria), is lacking.
Objective: This study aimed to compare CMR- and CCT-derived ventricular substrate models generated by ADAS 3D and inHEART in patients with ischemic and nonischemic cardiomyopathy undergoing ventricular tachycardia ablation.
Methods: Patients who underwent both CCT and late gadolinium enhancement CMR before ablation were retrospectively included. ADAS 3D models were generated on-site, whereas inHEART models were processed remotely. Substrate models were evaluated using a custom scoring system incorporating quantitative (scar mass, transmurality) and qualitative parameters (wall thickness, scar delineation, and conduction corridors). Electroanatomic maps (EAMs) assessed correspondence between low-voltage and ablation regions, with imaging-defined corridors.
Results: 16 patients (n = 8 ischemic, n = 8 nonischemic) were analyzed; 12 had detailed EAM data. Scar core and border zone measurements were comparable between platforms in both subgroups (all P > .05). ADAS 3D showed slightly higher visualization scores, particularly in nonischemic cardiomyopathy, although 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 the 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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