Peri-Procedural Transmural Electrophysiological Imaging of Scar-Related Ventricular Tachycardia

Status: Recruiting
Location: See location...
Intervention Type: Diagnostic test
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Ventricular tachycardia (VT) contributes to over 350,000 sudden deaths each year in the US. Malignant VTs involve an electrical short circuit in the heart, formed by narrow channels of surviving tissue inside myocardial scar. An important treatment is to use catheter ablation to block the channel that forms the circuit. Effective ablation requires imaging guidance to visualize the VT circuit relative to scar structures in 3D. Unfortunately, with conventional catheter mapping, up to 90% of the VT circuits are too short-lived to be mapped. For the 10% mappable VTs, their data are only available during ablation and limited to one ventricular surface. This inadequacy of functional VT data largely limits the knowledge about scar-related VT and ablation strategies, and reduces the ability of clinicians to identify ablation targets and assess ablation outcome. The central hypothesis of this proposal is that functional VT data, integrated with CT or MRI scar data in 3D, can improve VT ablation efficacy with pre-procedural identification of ablation targets and post-procedural mechanistic elucidation of ablation failure. This research builds on the rapidly increasing clinical interest in electrocardiographic imaging (ECGi), an emerging technique that obtains cardiac electrical activity through inverse reconstructions from ECGs. The specific objective is to push the boundary of ECGi to provide - as a conjunction to intra-procedural catheter mapping - pre-ablation and post-ablation imaging of functional VT circuits integrated with 3D scar structure.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 85
Healthy Volunteers: f
View:

• One or more episodes of sustained monomorphic VT

• Referred for catheter ablation

• Previously implanted ICD

• Signed the patient informed consent form

• Able and willing to comply with all pre-, post-, and follow-up testing and requirements

Locations
Other Locations
Canada
QEII HSC
RECRUITING
Halifax
Contact Information
Primary
John L Sapp, MD FRCPC
john.sapp@nshealth.ca
902 473 4272
Backup
Karen A Giddens
karen.giddens@nshealth.ca
902 473 2758
Time Frame
Start Date: 2019-11-01
Estimated Completion Date: 2027-03-31
Participants
Target number of participants: 20
Treatments
Experimental: EP Imaging and Testing
MRI images,120 lead body surface mapping and NIPS testing will be completed to correlate areas of VT scar.
Sponsors
Collaborators: Rochester Institute of Technology, Nova Scotia Health Authority
Leads: John Sapp

This content was sourced from clinicaltrials.gov