Delayed-enhanced magnetic resonance imaging in nonischemic cardiomyopathy: utility for identifying the ventricular arrhythmia substrate.
Delayed-enhanced magnetic resonance imaging in nonischemic cardiomyopathy: utility for identifying the ventricular arrhythmia substrate.
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DOI：
10.1016/j.jacc.2008.11.052
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发表时间：
2009-03-31
影响因子：
24
通讯作者：
Morady, Fred
中科院分区：
文献类型：
--
作者：
Bogun, Frank M.;Desjardins, Benoit;Good, Eric;Gupta, Sanjaya;Crawford, Thomas;Oral, Hakan;Ebinger, Matthew;Pelosi, Frank;Chugh, Aman;Jongnarangsin, Krit;Morady, Fred
本研究的目的是评估延迟增强磁共振成像（DE-MRI）指导非缺血性心肌病（NIC）患者室性心律失常消融的价值。在NIC患者中，室性心律失常通常与瘢痕组织相关。DE-MRI可用于精确定义疤痕组织。对29例（平均年龄50±15岁）NIC（平均射血分数37±9%）患者进行了DE-MRI检查，这些患者因室性心动过速（VT）或室性早搏（PVC）进行了导管消融。从DE-MRI中提取瘢痕，然后将其整合到电解剖图中。标测数据与瘢痕组织的定位相关。14/29例患者通过DE-MRI识别出瘢痕。这些患者中有9例有室性心动过速，5例有室性早搏。其中5例患者主要为内膜瘢痕，所有5例患者均从内膜有效进行了标测和心律失常消融。在2例患者中，瘢痕位于壁内或心外膜并延伸至内膜。在两例部分内膜瘢痕扩展的患者中，消融术有效消除了部分但非全部心律失常。在2例患者中，大部分瘢痕组织局限于心外膜;标测识别并消除了2例患者的心外膜起源。在其他5例主要为壁内瘢痕的患者中，对心律失常没有影响。既往无梗死患者的DE-MRI有助于识别致瘤基质;此外，它有助于计划适当的标测和消融策略。
The purpose of this study was to assess the value of delayed-enhanced magnetic resonance imaging (DE-MRI) to guide ablation of ventricular arrhythmias in patients with non-ischemic cardiomyopathy (NIC). In patients with NIC, ventricular arrhythmias often are associated with scar tissue. DE-MRI can be used to precisely define scar tissue. DE-MRI was performed in 29 consecutive patients (mean age 50±15 years) with NIC (mean ejection fraction 37±9%) referred for catheter ablation of ventricular tachycardia (VT) or premature ventricular complexes (PVCs). Scar was extracted from DE-MRIs and was then integrated into the electroanatomic map. Mapping data were correlated with respect to the localization of scar tissue. Scar was identified by DE-MRI in 14/29 patients. Nine of these patients had VT and five had PVCs. In 5 of the patients there was predominantly endocardial scar, and mapping and ablation of arrhythmias was effectively performed from the endocardium in all 5 patients. In 2 patients scar was either intramural or epicardial with extension to the endocardium. In both patients with partial endocardial scar extension, the ablation was effective in eliminating some but not all arrhythmias. In 2 patients most of the scar tissue was confined to the epicardium; mapping identified and eliminated an epicardial origin in both patients. No effect on arrhythmias could be achieved in the other 5 patients with predominantly intramural scar. DE-MRI in patients without prior infarctions can help to identify the arrhythmogenic substrate; furthermore it helps to plan an appropriate mapping and ablation strategy.
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影响因子：
24
作者：
Amado, LC;Gerber, BL;Lima, JAC
通讯作者：
Lima, JAC
影响因子：
24
作者：
de Cobelli, F;Pieroni, M;Del Maschio, A
通讯作者：
Del Maschio, A
影响因子：
24
作者：
Assomull, Ravi G.;Prasad, Sanjay K.;Pennell, Dudley J.
通讯作者：
Pennell, Dudley J.
DOI：
10.1016/0735-1097(95)00612-5
发表时间：
1996-04-01
影响因子：
24
作者：
deBakker, JMT;vanCapelle, FJL;Lahpor, JR
通讯作者：
Lahpor, JR
影响因子：
37.8
作者：
McCrohon, A;Moon, JCC;Pennell, DJ
通讯作者：
Pennell, DJ