A Case of a Low Displacement Area on Four-Dimensional Computed Tomography Corresponding to a Low Voltage Area on the Voltage Map

Recently, 4-dimensional computed tomography (4DCT) has become available for the preoperative planning of transcatheter aortic valve intervention.1 The 4DCT is reconstructed at 10% increments over the cardiac cycle, so that the 4DCT can evaluate not only the displacement of perivalvular structures but also the displacement of the myocardium.2 Most premature ventricular contractions (PVCs) arise from normal hearts. Further, it has been reported that PVCs arise from low-voltage areas and/or scar areas observed on voltage maps during electrophysiological studies, despite a structurally normal heart.3,4 Further, it has also been reported that a heterogeneous distribution of collagen within an infarct and the subendocardial layer is consistent with voltage mapping.5 From the above, we considered that an impaired myocardium would be displayed as having low dynamics on the 4DCT, whereas it would be displayed as a low-voltage or scar region on the voltage map. We herein describe our case, in which catheter ablation of PVCs was successfully performed, and a low-displacement area on the 4DCT corresponded to a low-voltage region on the voltage map.