BACKGROUND: Myocardial fat deposition (FAT-DEP) has been frequently observed in regions of chronic myocardial infarction in patients with ischemic cardiomyopathy. The role of FAT-DEP within scar-related ventricular tachycardia (VT) circuits has not been investigated. OBJECTIVE: This pilot study aimed to assess the impact of myocardial FAT-DEP on local electrograms and VT circuits in patients with ischemic cardiomyopathy. METHODS: Contrast-enhanced computed tomography was performed in 22 patients with ischemic VT. Electroanatomic map points were registered to the corresponding contrast-enhanced computed tomography images. Myocardial FAT-DEP was identified and characterized using a postprocessing image overlay that highlighted areas below 0 Hounsfield units (HU). The mean attenuation of local myocardial regions corresponding to sampled electrograms was measured on short-axis images. The associations of mean attenuation with bipolar and unipolar amplitudes, left ventricular wall thickness, and VT circuit sites were investigated. RESULTS: Of 1801 electroanatomic map points, 519 (28.8%) were located in regions with FAT-DEP. Significant differences were observed in mean intensity (23.2 ± 35.6 HU vs 81.7 ± 21.9 HU; P < .001), bipolar (0.75 ± 0.83 mV vs 2.9 ± 2.4 mV; P < .001) and unipolar (3.1 ± 1.7 mV vs 7.4 ± 4.3 mV; P < .001) amplitudes, and left ventricular wall thickness (5.2 ± 1.7 mm vs 8.2 ± 2.5 mm; P < .001) between regions with and without FAT-DEP. Lower HU was strongly associated with lower bipolar and unipolar amplitudes (P < .0001, respectively). Importantly, FAT-DEP was associated with critical VT circuit sites with fractionated or isolated potentials. CONCLUSION: FAT-DEP was associated with electrogram characteristics and VT circuit sites. Further work will be needed to determine whether FAT-DEP plays a causal role in the generation of ischemic scar-related VT circuits.
BACKGROUND: Myocardial fat deposition (FAT-DEP) has been frequently observed in regions of chronic myocardial infarction in patients with ischemic cardiomyopathy. The role of FAT-DEP within scar-related ventricular tachycardia (VT) circuits has not been investigated. OBJECTIVE: This pilot study aimed to assess the impact of myocardial FAT-DEP on local electrograms and VT circuits in patients with ischemic cardiomyopathy. METHODS: Contrast-enhanced computed tomography was performed in 22 patients with ischemic VT. Electroanatomic map points were registered to the corresponding contrast-enhanced computed tomography images. Myocardial FAT-DEP was identified and characterized using a postprocessing image overlay that highlighted areas below 0 Hounsfield units (HU). The mean attenuation of local myocardial regions corresponding to sampled electrograms was measured on short-axis images. The associations of mean attenuation with bipolar and unipolar amplitudes, left ventricular wall thickness, and VT circuit sites were investigated. RESULTS: Of 1801 electroanatomic map points, 519 (28.8%) were located in regions with FAT-DEP. Significant differences were observed in mean intensity (23.2 ± 35.6 HU vs 81.7 ± 21.9 HU; P < .001), bipolar (0.75 ± 0.83 mV vs 2.9 ± 2.4 mV; P < .001) and unipolar (3.1 ± 1.7 mV vs 7.4 ± 4.3 mV; P < .001) amplitudes, and left ventricular wall thickness (5.2 ± 1.7 mm vs 8.2 ± 2.5 mm; P < .001) between regions with and without FAT-DEP. Lower HU was strongly associated with lower bipolar and unipolar amplitudes (P < .0001, respectively). Importantly, FAT-DEP was associated with critical VT circuit sites with fractionated or isolated potentials. CONCLUSION:FAT-DEP was associated with electrogram characteristics and VT circuit sites. Further work will be needed to determine whether FAT-DEP plays a causal role in the generation of ischemic scar-related VT circuits.
Authors: Theodoros D Karamitsos; Jane M Francis; Saul Myerson; Joseph B Selvanayagam; Stefan Neubauer Journal: J Am Coll Cardiol Date: 2009-10-06 Impact factor: 24.094
Authors: J M Almendral; C D Gottlieb; M E Rosenthal; N J Stamato; A E Buxton; F E Marchlinski; J M Miller; M E Josephson Journal: Circulation Date: 1988-03 Impact factor: 29.690
Authors: Saman Nazarian; David A Bluemke; Albert C Lardo; Menekhem M Zviman; Stanley P Watkins; Timm L Dickfeld; Glenn R Meininger; Ariel Roguin; Hugh Calkins; Gordon F Tomaselli; Robert G Weiss; Ronald D Berger; João A C Lima; Henry R Halperin Journal: Circulation Date: 2005-11-01 Impact factor: 29.690
Authors: Benoit Desjardins; Thomas Crawford; Eric Good; Hakan Oral; Aman Chugh; Frank Pelosi; Fred Morady; Frank Bogun Journal: Heart Rhythm Date: 2009-02-14 Impact factor: 6.343
Authors: Tuna Ustunkaya; Benoit Desjardins; Riley Wedan; C Anwar A Chahal; Stefan L Zimmerman; Nissi Saju; Sohail Zahid; Apurva Sharma; Yuchi Han; Natalia Trayanova; Francis E Marchlinski; Hugh Calkins; Harikrishna Tandri; Saman Nazarian Journal: JACC Clin Electrophysiol Date: 2019-08-28
Authors: Satish Misra; Sohail Zahid; Adityo Prakosa; Nissi Saju; Harikrishna Tandri; Ronald D Berger; Joseph E Marine; Hugh Calkins; Vadim Zipunnikov; Natalia Trayanova; Stefan L Zimmerman; Saman Nazarian Journal: Heart Rhythm Date: 2018-06-02 Impact factor: 6.343
Authors: Eric Sung; Adityo Prakosa; Konstantinos N Aronis; Shijie Zhou; Stefan L Zimmerman; Harikrishna Tandri; Saman Nazarian; Ronald D Berger; Jonathan Chrispin; Natalia A Trayanova Journal: Circ Arrhythm Electrophysiol Date: 2020-11-16
Authors: Fabiola Bonezzi; Marco Piccoli; Michele Dei Cas; Rita Paroni; Alessandra Mingione; Michelle M Monasky; Anna Caretti; Chiara Riganti; Riccardo Ghidoni; Carlo Pappone; Luigi Anastasia; Paola Signorelli Journal: Front Physiol Date: 2019-08-09 Impact factor: 4.566
Authors: Usama A Daimee; Eric Sung; Marc Engels; Marc K Halushka; Ronald D Berger; Natalia A Trayanova; Katherine C Wu; Jonathan Chrispin Journal: Heart Rhythm O2 Date: 2022-04-02
Authors: Jimena G Siles-Paredes; Christopher J Crowley; Flavio H Fenton; Neal Bhatia; Shahriar Iravanian; Italo Sandoval; Stefan Pollnow; Olaf Dössel; João Salinet; Ilija Uzelac Journal: Front Physiol Date: 2022-08-12 Impact factor: 4.755