Document Detail

Virtual electrophysiological study in a 3-dimensional cardiac magnetic resonance imaging model of porcine myocardial infarction.
MedLine Citation:
PMID:  22633654     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study sought to test the hypothesis that "virtual" electrophysiological studies (EPS) on an anatomic platform generated by 3-dimensional magnetic resonance imaging reconstruction of the left ventricle can reproduce the reentrant circuits of induced ventricular tachycardia (VT) in a porcine model of myocardial infarction.
BACKGROUND: Delayed-enhancement magnetic resonance imaging has been used to characterize myocardial infarction and "gray zones," which are thought to reflect heterogeneous regions of viable and nonviable myocytes.
METHODS: Myocardial infarction by coronary artery occlusion was induced in 8 pigs. After a recovery period, 3-dimensional cardiac magnetic resonance images were obtained from each pig in vivo. Normal areas, gray zones, and infarct cores were classified based on voxel intensity. In the computer model, gray zones were assigned slower conduction and longer action potential durations than those for normal myocardium. Virtual EPS was performed and compared with results of actual in vivo programmed stimulation and noncontact mapping.
RESULTS: The left ventricular volumes ranged from 97.8 to 166.2 cm(3), with 4.9% to 17.5% of voxels classified as infarct zones. Six of the 7 pigs in which VT developed during actual EPS were also inducible with virtual EPS. Four of the 6 pigs that had simulated VT had reentrant circuits that approximated the circuits seen with noncontact mapping, whereas the remaining 2 had similar circuits but propagating in opposite directions.
CONCLUSIONS: This initial study demonstrates the feasibility of applying a mathematical model to magnetic resonance imaging reconstructions of the left ventricle to predict VT circuits. Virtual EPS may be helpful to plan catheter ablation strategies or to identify patients who are at risk of future episodes of VT.
Jason Ng; Jason T Jacobson; Justin K Ng; David Gordon; Daniel C Lee; James C Carr; Jeffrey J Goldberger
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-05-23
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  60     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-27     Completed Date:  2012-10-09     Revised Date:  2013-08-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  423-30     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Division of Cardiology and Bluhm Cardiovascular Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
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MeSH Terms
Cicatrix / physiopathology
Computer Simulation*
Contrast Media
Death, Sudden, Cardiac / pathology
Disease Models, Animal*
Electric Stimulation
Gadolinium DTPA / diagnostic use
Heart Conduction System / physiopathology
Image Interpretation, Computer-Assisted*
Imaging, Three-Dimensional*
Magnetic Resonance Imaging*
Models, Theoretical
Myocardial Infarction / physiopathology*
Myocardium / pathology
Signal Processing, Computer-Assisted*
Tachycardia, Ventricular / physiopathology
User-Computer Interface*
Ventricular Dysfunction, Left / physiopathology
Grant Support
1 R21 HL094902-01/HL/NHLBI NIH HHS; R21 HL094902/HL/NHLBI NIH HHS
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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