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Volume 14, Issue 8, Pages (August 2017)

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1 Volume 14, Issue 8, Pages 1121-1128 (August 2017)
Cardiac magnetic resonance–aided scar dechanneling: Influence on acute and long- term outcomes  David Andreu, MSc, PhD, Diego Penela, MD, Juan Acosta, MD, Juan Fernández-Armenta, MD, PhD, Rosario J. Perea, MD, PhD, David Soto-Iglesias, MSc, Teresa M. de Caralt, MD, PhD, Jose T. Ortiz-Perez, MD, PhD, Susana Prat-González, MD, PhD, Roger Borràs, MSC, Eduard Guasch, MD, PhD, Jose María Tolosana, MD, PhD, Lluis Mont, MD, PhD, Antonio Berruezo, MD, PhD  Heart Rhythm  Volume 14, Issue 8, Pages (August 2017) DOI: /j.hrthm Copyright © 2017 The Authors Terms and Conditions

2 Figure 1 Integration of LGE-CMR information into the navigation system. A: Inferior view of the endocardial bipolar voltage electroanatomic map from a patient with an ischemic scar. Electrograms with delayed components were classified as conducting channel entrance (black dots, 1 and 4) or inner conducting channel (blue dots, 2 and 3) points, depending on delayed-component lateness during sinus rhythm. Red dots show the radiofrequency application points. B: Signal intensity map obtained from late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Areas with hyperenhancement (dense scar) are coded in red, normal myocardium is coded in purple, and border zone is coded in blue-green-yellow. The heterogeneous tissue channel can be observed inside the scar. C: Registration of the electroanatomic map with the LGE-CMR reconstruction. Corridors formed by conducting channel points (blue and black dots) are present in the scar tissue. Heart Rhythm  , DOI: ( /j.hrthm ) Copyright © 2017 The Authors Terms and Conditions

3 Figure 2 A and B Scar dechanneling ablation protocol and the identification process for heterogeneous tissue channels or conducting channels. Heart Rhythm  , DOI: ( /j.hrthm ) Copyright © 2017 The Authors Terms and Conditions

4 Figure 3 Kaplan-Meier curves for the end point of ventricular tachycardia recurrence. A: Patients with and without cardiac magnetic resonance (CMR)–aided ablation. B: Patients from the control group with CMR information used to select procedural approach, patients with pixel signal intensity map integration, and patients without CMR. Heart Rhythm  , DOI: ( /j.hrthm ) Copyright © 2017 The Authors Terms and Conditions

5 Supplemental Figure 1A Heart Rhythm  , DOI: ( /j.hrthm ) Copyright © 2017 The Authors Terms and Conditions

6 Supplemental Figure 1B Heart Rhythm  , DOI: ( /j.hrthm ) Copyright © 2017 The Authors Terms and Conditions

7 Supplemental Figure 2 Heart Rhythm  , DOI: ( /j.hrthm ) Copyright © 2017 The Authors Terms and Conditions


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