Importance of cardiac imaging in patients with ventricular tachycardia

Importance of cardiac imaging in patients with ventricular tachycardia

Late gadolinium enhancement on cardiac magnetic resonance imaging identifies scars likely to cause reentrant ventricular tachycardia. Ischemic scars are predominantly subendocardial while post inflammatory scars are predominantly sub epicardial. Scar in dilated cardiomyopathy is located in the mid wall region.

Imaging data is thus useful in deciding on the access (endocardial or epicardial approach) for ablation of ventricular tachycardia. Imaging will also tell us whether there is pericardial calcification which may interfere with catheter navigation in pericardial space in case of epicardial ablation. Similarly presence of intracardiac thrombus as delineated by imaging will be considered a potential risk for embolisation in case of endocardial ablation.

Reference

1. Mahida S et al.Cardiac Imaging in Patients With Ventricular Tachycardia.  Circulation. 2017;136:2491-2507.