Identification of Myocardial Scar in Ventricular Tachycardia: Correlation between CT based results and Electro-Anatomic Map Findings

The purpose of this work was to compare an image-based parametric myocardium mesh automatically segmented from multidetector computed tomographic (MDCT) volumes with the findings of electro-anatomic maps (EAM) constructed previously to radiofrequency ablation (RFa) procedures. The myocardium mesh presents distance information about myocardial thickness, as well as the localization of scar detected using a delayed enhanced DE-MDCT scan. Additionally, possible zones of epicardial fat with thickness greater than 3mm were also identified on patients that underwent an epicardial intervention. The comparison was performed on 5 patients with recurrent ventricular tachycardia (VT) undergoing angiographic and DE-MDCT scan before EAM and RFa, of which 3 patients underwent endocardial and 2 patients an epicardial procedure. We compared the findings of the myocardium mesh against EAM and our results suggest that the mesh could be an important tool for the prediction of myocardial scar localization.