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3-D CT Scans May Improve Heart Ablation

August 19, 2010
Written by: , Filed in: Cardiac Imaging, Interventional Radiology
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A new 3-D CT scanning approach may improve treatment for the potentially life-threatening heart disorder ventricular tachycardia. Current ablation treatment for the disorder, which can develop following a heart attack, has a long-term success rate of only 50 to 60 percent.

Researchers at the University of Maryland School of Medicine in Baltimore spent two years testing and customizing software to come up with the new CT technique. It combines images of abnormal cardiac anatomy, blood flow, and heart muscle contraction into a three-dimensional format that can work with existing equipment to guide radiofrequency ablation.

The results of their feasibility study have been published online in Circulation: Arrhythmia and Electrophysiology, a journal of the American Heart Association.

Timm-Michael L. Dickfeld, MD, PHD, associate professor of medicine at the University of Maryland School of Medicine and the study’s senior author, said the new imaging procedure should allow treatment to be more precise and take less time.

“We can use 3-D CT imaging to guide us more rapidly to areas of the heart that may cause the electrical abnormalities responsible for ventricular tachycardia, and move away from parts of the heart that do not contribute to the abnormalities,” Dr. Dickfeld said, as quoted in a Maryland Medical Center news release.

Scar tissue in the heart may block or short-circuit the flow of electrical impulses, causing ventricular tachycardia—rapid, irregular heartbeat. This study evaluated 11 men who had survived heart attacks and who had developed ventricular tachycardia. Each had a cardioverter-defibrillator implanted to correct the heartbeat problems, and each received an ablation procedure.

The participants were scanned for 10 to 15 seconds with a 64-slice CT system. The scan data were reconstructed into 3-D images and compared to the results of the clinical electrical mapping system that’s normally used to guide ablations (and which can take several hours and require considerable X-ray exposure).

The study used CT imaging only as a supplement to find the location of scars, which it did 82 percent of the time. The next step, the researchers said, would be a randomized, controlled trial to determine how much time the new technique would save, how much less radiation it would require than electrical mapping, and what impact it would have on patient care.

Related seminar: Cardiac Imaging (new release)


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