Abstract 16194: Specific Organized Substrates of Ventricular Fibrillation: Comparison of 320-Slice CT Heart Images in Subjects With Ventricular Fibrillation and Subjects With Sustained or Non-Sustained Ventricular Tachycardia
Purpose: If specific organized substrates of ventricular fibrillation (VF) are identified, they may provide important information for prevention of sudden cardiac death. 320 slice CT can acquire heart images in one heart beat and even if arrhythmia occurs during acquisition, clear heart images can be obtained. We compared 320 slice CT heart images in subjects who had VF with those who had sustained and non sustained ventricular tachycardia (VT).
Material and Methods: A total of 50 subjects who had VF (9 subjects; age, 64±11 yrs), sustained VT (8 subjects; age, 65±21 yrs) or non sustained VT (33 subjects; age, 58±16 yrs) underwent 320 slice CT (Aquilon one). If there was a contrast defect in myocardium in early phase, late phase acquisition was added, and if abnormal late enhancement was observed in the corresponding site, we diagnosed myocardial fibrosis. If the contrast defect continued in late phase with CT values < 0 HU, we diagnosed myocardial fatty change.
Result: There were no significant difference in age, percentage of males, hyperlipidemia, or usage of angiotensin type 2 blockers, beta-blockers, or statins among the 3 groups. Hypertension was more common in sustained VT group than in non sustained VT and VF groups (both p<0.05). On CT, there were no significant differences in percentage of coronary arteries with >50% stenosis among the 3 groups, but myocardial fibrosis was significantly more common in VF group (66%, all myocardial fibrosis was in left ventricle) than in non sustained VT group (28%) (p<0.05). Myocardial fatty change was significantly more common in sustained VT group (50%, half of myocardial fatty change was in right ventricle) than in non sustained VT group (17%) (p<0.05).
Conclusions: Myocardial fibrosis and fatty change may be substrates of VF or sustained VT. 320 slice CT can evaluate coronary arteries and myocardium in subjects with arrhythmia and even with implantable cardioverter defibrillators which cannot be acquired on magnetic resonance imaging.
- © 2011 by American Heart Association, Inc.