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Prakosa A, Arevalo HJ, Deng D, et al. Personalized virtual-heart technology for guiding the ablation of infarct-related ventricular tachycardia. Nat Biomed Eng. 2018;2(10):732-740doi: 10.1038/s41551-018-0282-2.
Prakosa, A., Arevalo, H. J., Deng, D., Boyle, P. M., Nikolov, P. P., Ashikaga, H., Blauer, J. J. E., Ghafoori, E., Park, C. J., Blake, R. C., Han, F. T., MacLeod, R. S., Halperin, H. R., Callans, D. J., Ranjan, R., Chrispin, J., Nazarian, S., & Trayanova, N. A. (2018). Personalized virtual-heart technology for guiding the ablation of infarct-related ventricular tachycardia. Nature biomedical engineering, 2(10), 732-740. https://doi.org/10.1038/s41551-018-0282-2
Prakosa, Adityo, et al. "Personalized virtual-heart technology for guiding the ablation of infarct-related ventricular tachycardia." Nature biomedical engineering vol. 2,10 (2018): 732-740. doi: https://doi.org/10.1038/s41551-018-0282-2
Prakosa A, Arevalo HJ, Deng D, Boyle PM, Nikolov PP, Ashikaga H, Blauer JJE, Ghafoori E, Park CJ, Blake RC, Han FT, MacLeod RS, Halperin HR, Callans DJ, Ranjan R, Chrispin J, Nazarian S, Trayanova NA. Personalized virtual-heart technology for guiding the ablation of infarct-related ventricular tachycardia. Nat Biomed Eng. 2018 Oct;2(10):732-740. doi: 10.1038/s41551-018-0282-2. Epub 2018 Sep 03. PMID: 30847259; PMCID: PMC6400313.
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Nat Biomed Eng. 2018 Oct;2(10):732-740. doi: 10.1038/s41551-018-0282-2. Epub 2018 Sep 03.

Personalized virtual-heart technology for guiding the ablation of infarct-related ventricular tachycardia.

Nature biomedical engineering

Adityo Prakosa, Hermenegild J Arevalo, Dongdong Deng, Patrick M Boyle, Plamen P Nikolov, Hiroshi Ashikaga, Joshua J E Blauer, Elyar Ghafoori, Carolyn J Park, Robert C Blake, Frederick T Han, Rob S MacLeod, Henry R Halperin, David J Callans, Ravi Ranjan, Jonathan Chrispin, Saman Nazarian, Natalia A Trayanova

Affiliations

  1. Institute for Computational Medicine and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
  2. Cardiac Modelling Department, Simula Research Laboratory, Fornebu, Norway.
  3. Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  4. Department of Bioengineering, University of Utah, Salt Lake City, UT, USA.
  5. University of Utah Health Sciences Center, Salt Lake City, UT, USA.
  6. Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  7. Institute for Computational Medicine and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA. [email protected].
  8. Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. [email protected].

PMID: 30847259 PMCID: PMC6400313 DOI: 10.1038/s41551-018-0282-2

Abstract

Ventricular tachycardia (VT), which can lead to sudden cardiac death, occurs frequently in patients with myocardial infarction. Catheter-based radiofrequency ablation of cardiac tissue has achieved only modest efficacy, owing to the inaccurate identification of ablation targets by current electrical mapping techniques, which can lead to extensive lesions and to a prolonged, poorly tolerated procedure. Here we show that personalized virtual-heart technology based on cardiac imaging and computational modelling can identify optimal infarct-related VT ablation targets in retrospective animal (5 swine) and human studies (21 patients) and in a prospective feasibility study (5 patients). We first assessed in retrospective studies (one of which included a proportion of clinical images with artifacts) the capability of the technology to determine the minimum-size ablation targets for eradicating all VTs. In the prospective study, VT sites predicted by the technology were targeted directly, without relying on prior electrical mapping. The approach could improve infarct-related VT ablation guidance, where accurate identification of patient-specific optimal targets could be achieved on a personalized virtual heart prior to the clinical procedure.

Conflict of interest statement

Competing Interests. NAT holds partial ownership of CardioSolv Ablation Technologies LLC. SN is a scientific advisor to CardioSolv Ablation Technologies LLC. The other authors declare no competing fin

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