Abstract 20903: A Novel Approach to Arrhythmia Risk Stratification in Patients With Non-ischemic Cardiomyopathy
Introduction: We have recently developed a novel non-invasive and accurate test for arrhythmia risk stratification in ischemic cardiomyopathy patients, termed Virtual Arrhythmia Risk Prediction (VARP), using 3D computer models of patients’ hearts reconstructed from LGE MRI data. Here we present the extension of the approach to patients with non-ischemic cardiomyopathy (NICM).
Methods: We piloted 2 patients with documented NICM that underwent invasive electrophysiological study (EPS) during ICD implantation. Later, both patients experienced VT episodes requiring ICD shocks. Personalized heart models of these patients were reconstructed from LGE MRI acquired prior to clinical EPS. Following semi-automated segmentation, a modified full-width-half-max method was used to identify scar tissue (Fig A). We then applied our VARP protocol from 17 sites in LV and 9 sites in RV (Fig B) to probe VT induction.
Results: Our VARP protocol induced VTs in both models, revealing figure-of-eight reentries in the anterior LV of model 1 (Fig C) and superior LV septum of model 2 (Fig D). These were consistent with clinical VT morphologies as determined from the 12-lead ECG evaluation during clinical EPS. Simulation results were able to pinpoint the critical scar region that anchored the VT in each model.
Conclusion: VARP may be applied successfully as a novel non-invasive arrhythmia risk stratification approach in NICM patients.
Author Disclosures: P. Nikolov: None. A. Prakosa: None. H.J. Arevalo: None. K.C. Wu: None. N. Trayanova: Ownership Interest; Significant; Cardiosolv, LLC..
- © 2016 by American Heart Association, Inc.