Scar conducting channel wall thickness characterization to predict arrhythmogenicity during ventricular tachycardia ablation

Abstract

The obtention of cardiac images before the surgery ablation of ventricular tachycardia is widely used to obtain more and better information from the patient than the information obtained during the procedure. This technique is commonly performed using cardiac magnetic resonance since it allows to study and characterise the tissue, which is crucial to detect quantify scarred tissue and the particular region that triggers the tachycardia. In this project, the arrhythmogenicity of different conducting channels from patients subjected to ventricular tachycardia ablation has been studied along with their wall thickness in order to assess a correlation using late gadolinium enhancement cardiac magnetic resonance imaging. In addition, the correlation between the left ventricle wall thickness of the conducting channels and the outcome of the cardiac catheter ablation performed from the endocardial region of the heart has also been studied. This project emerges from a previous study performed in the Hospital Clínic de Barcelona that characterized several features of the main conducting channel that triggers the ventricular tachycardia. To perform this study, the images used and the information regarding the arrhythmogenic conducting channel of every patient were obtained from the previous research, using 26 patients for the main objective of this project and using 10 of them for the study of the outcome of the ventricular tachycardia ablation The study of the wall thickness and the visualization of the conducting channels were performed using ADAS 3D software. Results showed that there was not a significative difference between the wall thickness from arrhythmogenic conducting channels and from the non-arrhythmogenic conducting channels within the patients studied but it is important to highlight that the p-value obtained was too large, which might have been caused by the lack of patients to include to this study. However, an interesting distribution of the arrhythmogenic conducting channel was noticed in the inferior-septum region of the heart, which is interesting to study further in the future using more patients and, hence, more conducting channels to study. To conclude, it is important to highlight the role of technology and biomedical engineering in this field to achieve better image acquisition to improve therapeutical techniques for the patient and this project has contributed to the awareness and the comprehension of the role of a biomedical engineer in a clinical environment.