High-Resolution 3D Scar Imaging Using a Novel Late Iodine Enhancement Multidetector CT Protocol to Guide Ventricular Tachycardia Catheter Ablation


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Address for correspondence: Vijay S. Chauhan M.D. F.R.C.P.C., PMCC 3-522 (Gerrard Wing), Toronto General Hospital, 150 Gerrard St. W., Toronto, ON, M5G 2C4, Canada. Fax: +416-340-4710; E-mail: vijay.chauhan@uhn.on.ca

Myocardial Scar Characterization with CT

Scar delineation with late gadolinium-enhanced MRI can direct VT substrate mapping and ablation, but imaging is poor and relatively contraindicated in the majority of patients with ICDs. We present a case of scar definition using late iodine-enhanced multidetector CT in a patient with ischemic cardiomyopathy and multiple ICD shocks for VT. CT images were acquired using a novel intracoronary contrast delivery protocol which provided high-resolution subendocardial scar visualization. The segmented scar images were subsequently imported into an electroanatomic mapping platform to guide successful VT ablation.