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J Nucl Cardiol. 2021 Feb;28(1):175-183. doi: 10.1007/s12350-018-01575-x. Epub 2019 Jan 02.

Predictors of ventricular ablation's success: Viability, innervation, or mismatch?.

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

Alessia Gimelli, Francesca Menichetti, Ezio Soldati, Riccardo Liga, Nicola Scelza, Giulio Zucchelli, Andrea Di Cori, Luca Segreti, Andrea Vannozzi, Maria Grazia Bongiorni, Paolo Marzullo

Affiliations

  1. Fondazione Toscana G. Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy. [email protected].
  2. Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy.
  3. Sant'Anna, School of Advanced Studies, Pisa, Italy.
  4. Fondazione Toscana G. Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy.
  5. CNR, Institute of Clinical Physiology, Pisa, Italy.

PMID: 30603891 DOI: 10.1007/s12350-018-01575-x

Abstract

AIMS: Sympathetic dys-innervation may play an important role in the development of post-ischemic ventricular arrhythmias (VA). Aim of this study was to prove that perfusion/innervation mismatch (PIM) evaluated by SPECT can identify areas of local abnormal ventricular activities (LAVA) on electroanatomic mapping (EAM).

METHODS: Sixteen patients referred to post-ischemic VA catheter ablation underwent pre-procedural and 1-month post-ablation

RESULTS: Before ablation, the mean voltage in the PIM segments was higher than in the scarred ones but lower than in the normal regions. The presence of PIM in a specific LV zone was an independent predictor of LAVA. After ablation, PIM value was significantly reduced, mainly due to an increase in perfusion summed rest score, in particular in patients that were responders to ablation.

CONCLUSIONS: PIM may associate with VA substrate expressed by LAVA and might provide a novel guide for substrate ablation. A significant reduction of PIM could predict a positive clinical response to ablation.

Keywords: Intervention tracers; cardiac innervation; diagnostic and prognostic application; image-guided application; multimodality

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