Abstract 19251: Identification of Conducting Channels by Delayed Enhanced Cardiac Magnetic Resonance Imaging

Objective: Delayed enhanced cardiac magnetic resonance imaging (DE-CMRI) is able to define a heterogeneous zone of fibrotic tissue and surviving myocytes, known as ‘gray zone’ (GZ). Studies suggest that the GZ is related to ventricular tachycardia (VT) slow conducting channels (CC). There are established algorithms for GZ characterization. We evaluated the correlation of DE-CMRI defined CC and VT electroanatomic maps (EAM). Methods: Preprocedural DE-CMRI for scar evaluation and electrophysiology study were done in 14 male patients with ischemic (10) and non-ischemic (4) cardiomyopathy and VT. GZ was assessed on contiguous two-dimensional (2D) short axis DE-CMRI slices and reconstructed three-dimensional (3D) models. The reconstructed scar models were integrated in a clinical mapping system and compared to EAM. GZ were defined based on previously described signal intensity (SI) thresholds; full-width half maximum (FWHM), n-standard deviation (NSD) using 2-3SD thresholds and ‘Roes’ (≥ 35% - 50% of peak SI a...