Specific organized substrates of ventricular fibrillation: comparison of 320-slice CT heart images in non-ischemic ventricular fibrillation subjects with non-ischemic sustained and non-sustained ventricular tachycardia subjects.
OBJECTIVE
If specific organized substrates of ventricular-fibrillation (VF) are identified, they may provide important-information for prevention of sudden-cardiac-death. To identify specific organized substrates of VF, we compared 320-slice CT heart images in non-ischemic VF subjects with non-ischemic sustained and non-sustained ventricular-tachycardia (VT) subjects.


METHODS
Retrospective analysis of a total of 103 subjects who had VF (17 subjects; age, 59 ± 16 years), sustained VT (20 subjects; 62 ± 19 years), or non-sustained VT (66 subjects; 60 ± 15 years) underwent 320-slice CT (Aquilion one).


RESULTS
After excluding 26 ischemic subjects with >50% stenosis in any coronary arteries on CT, myocardial infarction, or coronary vasospastic angina, a total of 77 non-ischemic subjects (12 VF subjects; age, 58 ± 18 years), (13 sustained VT subjects; 55 ± 20 years) or (52 non-sustained VT subjects; 58 ± 15 years) were analyzed. On CT, myocardial abnormal-late-enhancement was significantly more frequent in the VF group (75%, all myocardial abnormal-late-enhancement in left-ventricle) than in the sustained VT group (31%) and the non-sustained VT group (35%) (both P<0.01). Myocardial fatty change was significantly more frequent in the sustained VT group (54%) than in the VF group (17%) and the non-sustained VT group (12%) (both P<0.01). Final diagnoses of the non-ischemic VF and sustained groups included four subjects in each case with normal cardiac structure on transthoracic echocardiogram; the former included two subjects who had abnormal-late-enhancement on CT without specific ECG findings.


CONCLUSIONS
Myocardial abnormal-late-enhancement and fatty change on CT may be substrates of VF or sustained VT in non-ischemic subjects. 320-slice CT can evaluate both coronary arteries and myocardium.
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
Koya
K
Ozawa
Nobusada
N
Funabashi
Hiroyuki
H
Takaoka
Masae
M
Uehara
Yoshio
Y
Kobayashi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014693:Ventricular Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology
320- slice CT; Non-ischemic; Specific organized substrates; Sustained and non-sustained ventricular tachycardia; Ventricular fibrillation