Post-Myocardial Infarction Scar With Fat Deposition Shows Specific Electrophysiological Properties and Worse Outcome After Ventricular Tachycardia Ablation

Background Fat deposition (FD) is part of the healing process after myocardial infarction. The characteristics of FD and its impact on the outcome in patients undergoing ventricular tachycardia (VT) ablation have not been thoroughly studied. Methods and Results We studied consecutive patients underg...

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Bibliographic Details
Published in:Journal of the American Heart Association 2019-08, Vol.8 (15), p.e012482-e012482
Main Authors: Cheniti, Ghassen, Sridi, Soumaya, Sacher, Frederic, Chaumeil, Arnaud, Pillois, Xavier, Takigawa, Masateru, Frontera, Antonio, Vlachos, Konstantinos, Martin, Claire A, Teijeira, Elvis, Kitamura, Takeshi, Lam, Anna, Bourier, Felix, Puyo, Stephane, Duchateau, Josselin, Denis, Arnaud, Pambrun, Thomas, Chauvel, Remi, Derval, Nicolas, Laurent, François, Montaudon, Michel, Hocini, Meleze, Haissaguerre, Michel, Jais, Pierre, Cochet, Hubert
Format: Article
Language:English
Subjects:
Adipose Tissue - pathology
Aged
Catheter Ablation
Cicatrix - etiology
Cicatrix - pathology
Cicatrix - physiopathology
computed tomography
Electrophysiologic Techniques, Cardiac
Electrophysiological Phenomena
fat deposition
Female
Humans
Male
Middle Aged
myocardial infarction
Myocardial Infarction - complications
Myocardial Infarction - pathology
Myocardial Infarction - physiopathology
Original Research
Prognosis
Tachycardia, Ventricular - etiology
Tachycardia, Ventricular - surgery
Treatment Outcome
ventricular tachycardia
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Summary:Background Fat deposition (FD) is part of the healing process after myocardial infarction. The characteristics of FD and its impact on the outcome in patients undergoing ventricular tachycardia (VT) ablation have not been thoroughly studied. Methods and Results We studied consecutive patients undergoing post-myocardial infarction VT ablation with pre-procedural cardiac computed tomography. FD was defined as intra-myocardial attenuation ≤ -30 HU on computed tomography. Clinical, anatomical, and post-procedural outcome was assessed in the overall population. Electrophysiological characteristics were assessed is a subgroup of patients with high-density electro-anatomical maps. Sixty-nine patients were included (66±12 years). FD was detected in 44 (64%) patients. The presence of FD related to scar age (odds ratio [OR]: 1.14 per year; P=0.001) and scar extent (OR: 1.27 per segment; P=0.02). On electro-anatomical maps, FD was characterized by lower bipolar amplitude (P
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.119.012482