Septal late enhancement by cardiac CT is associated with repeat ablation in nonischemic cardiomyopathy patients

• DOI: 10.1111/jce.16356
• Publication Date: 2024-07-12T10:05:21Z
• Authors: Leah A. John; Sanjay Divakaran; Ron Blankstein; Uyanga Batnyam; Pal Suranyi; Mathew Gregoski; Hubert Cochet; Jean‐Marc Peyrat; Nicolas Cedlink; Luis Kabongo; Bruno Soré; Joseph Schoepf; William H. Sauer; Jeffrey R. Winter...; Usha B. Tedrow
• Keywords: Interquartile range

Abstract Introduction Scar substrate in nonischemic cardiomyopathy (NICM) patients is often difficult to identify. Advances cardiac imaging, especially using late iodine‐enhanced computed tomography (LIE‐CT), allow better characterization of scars giving rise ventricular tachycardia (VT). Currently, there are limited data on clinical correlates CT‐derived scar substrates NICM. We sought assess the relationship between location LIE‐CT and outcomes after radiofrequency catheter ablation (RFCA) NICM with VT. Methods From 2020 2022, consecutive undergoing VT RFCA integration CT modeling (inHeart, Pessac, France) were included at two US tertiary care centers. The protocol both arterial‐enhanced imaging for anatomical assessment. distribution was analyzed relation patient outcomes, primary endpoints being recurrence need repeat procedure. Results Sixty (age 64 ± 12 years, 90% men). Over a median follow‐up 120 days (interquartile range [IQR]: 41–365), procedures required 32 (53%). occurred 46 (77%), time 40 (IQR: 8–65). total volume positively correlated intrinsic QRS duration ( r = .34, p 0.008). Septal found 34 (57%), lateral (7%). On univariate logistic regression, septal associated increased odds (odds ratio [OR]: 2.9 [1.0–8.4]; 0.046), while not (OR: 0.9 [0.3–2.7]; 0.855). predicted when compared scar, but neither statistically significant (septal OR: 3.0 [0.9–10.7]; 0.078; 1.7 [0.5–5.9]; 0.391). Conclusion In this referral population, have nearly threefold risk ablation.