title: Delayed-enhanced MR scar imaging and intraprocedural registration into an electroanatomical mapping system in post-infarction patients.
abstract: Post-infarction arrhythmias are most often confined to scar tissue. Scar can be detected by delayed-enhanced cardiac magnetic resonance. The purpose of this study was to assess the feasibility of pre-procedural scar identification and intraprocedural real-time image registration with an electroanatomical map in 23 patients with previous infarction and ventricular arrhythmias (VAs). Registration accuracy and cardiac magnetic resonance/electroanatomical map correlations were assessed, and critical areas for VA were correlated with the presence of scar. With a positional registration error of 3.8 ± 0.8 mm, 86% of low-voltage points of the electroanatomical map projected onto the registered scar. The delayed-enhanced cardiac magnetic resonance-defined scar correlated with the area of low voltage (R = 0.82, p < 0.001). All sites critical to VAs projected on the registered scar. Selective identification and extraction of delayed-enhanced cardiac magnetic resonance defined scar followed by registration into a real-time mapping system are feasible and help to identify and display the arrhythmogenic substrate in post-infarction patients with VAs.
authors.affiliation: University of Michigan Medical Center, Ann Arbor, Michigan, USA.
authors.forename: Sanjaya
authors.initials: S
authors.lastname: Gupta
authors.forename: Benoit
authors.initials: B
authors.lastname: Desjardins
authors.forename: Timir
authors.initials: T
authors.lastname: Baman
authors.forename: Karl
authors.initials: K
authors.lastname: Ilg
authors.forename: Eric
authors.initials: E
authors.lastname: Good
authors.forename: Thomas
authors.initials: T
authors.lastname: Crawford
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
authors.forename: Frank
authors.initials: F
authors.lastname: Pelosi
authors.forename: Aman
authors.initials: A
authors.lastname: Chugh
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
authors.forename: Frank
authors.initials: F
authors.lastname: Bogun
mesh_terms: D017115:Catheter Ablation; D002921:Cicatrix / Q000175:diagnosis*; D003287:Contrast Media; D022062:Electrophysiologic Techniques, Cardiac; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D017180:Tachycardia, Ventricular / Q000150:complications / Q000601:surgery*; D018879:Ventricular Premature Complexes / Q000150:complications / Q000601:surgery*
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA