The Use of CT to Identify Damaged Heart Muscle in Patients Undergoing Ventricular Tachycardia Ablation.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00583284
Recruitment Status : Terminated (key study staff left foundation)
First Posted : December 31, 2007
Last Update Posted : January 20, 2017
Information provided by (Responsible Party):
The Cleveland Clinic

December 20, 2007
December 31, 2007
January 20, 2017
November 2006
March 2008   (Final data collection date for primary outcome measure)
Areas of hyperenhanced myocardium, as determined by delayed enhancement CT, correlate with the findings on voltage mapping of the LV in patients with a prior myocardial infarction who are undergoing VT ablation. [ Time Frame: 1 week ]
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Complete list of historical versions of study NCT00583284 on Archive Site
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The Use of CT to Identify Damaged Heart Muscle in Patients Undergoing Ventricular Tachycardia Ablation.
Utility of Delayed-Enhancement Multi-Detector Computed Tomography Imaging in Identifying Arrhymogenic Substrate in Patients Undergoing Catheter Ablation for Ventricular Tachycardia
Patients with ventricular tachycardia (VT) undergo catheter ablation. During the ablation procedure, the heart is mapped to determine areas of heart muscle damage. The heart scarring areas are often the source of the VT. Delayed enhancement CT has recently been used to determine areas of scarring . This study is to determine if the areas of damaged heart muscle mapped with the delayed enhancement CT correlate with the same areas that are determined during the catheter ablation.
Catheter ablation of ventricular tachycardia (VT) is performed in patients who have recurrent VT despite the use of other therapies. Electroanatomic mapping of the left ventricular myocardium is performed as part of these procedures to define the arrhythmogenic substrate for subsequent ablation. We hypothesize that delayed enhancement multi-detector computed tomography (MDCT) will identify areas of myocardial scarring or fibrosis that correlate with findings of voltage mapping in patients with a prior myocardial infarction who are undergoing VT ablation. We will perform a pilot study involving 10 patients with coronary artery disease scheduled for VT ablation to determine the ability of delayed enhancement MDCT to identify arrhythmogenic substrates in these patients, when compared with electroanatomic mapping. All patients will undergo a standard of care 64-slice MDCT study, followed 5 minutes later by the research delayed enhancement acquisition. We will evaluate the relationship between hyperenhanced myocardium, as detected by delayed enhancement MDCT, and abnormal myocardium detected on voltage mapping, defined as areas of myocardium with < 0.5 mV signal amplitude. Studies will be performed on the new Siemens 64-slice dual source CT scanner, which reduces radiation exposure from the scan by 33-50%. This study will generate preliminary data which will be used for subsequent NIH/AHA grant applications or industry sponsored trials.
Observational Model: Case-Only
Time Perspective: Prospective
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Non-Probability Sample
Patients coming to Cleveland Clinic for catheter ablation for ventricular tachycardia
Ventricular Tachycardia
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Kim RJ, Fieno DS, Parrish TB, Harris K, Chen EL, Simonetti O, Bundy J, Finn JP, Klocke FJ, Judd RM. Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation. 1999 Nov 9;100(19):1992-2002.

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
March 2008
March 2008   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Age > 21 years
  • Prior myocardial infarction
  • Scheduled for CT scan < 1 week prior to VT ablation for ventricular arrythmia

Exclusion Criteria:

  • Serum creatinine > 1.8 mg/dL
  • Contrast dye allergy
  • Atrial fibrillation
  • Unable to lie flat for the duration of image acquistion (15-20 minutes)
  • Clinical instability at time of CT study acquisition
  • Women of childbearing potential
  • Personal or social problems that might prevent compliance with the study
Sexes Eligible for Study: All
21 Years and older   (Adult, Older Adult)
Contact information is only displayed when the study is recruiting subjects
United States
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Plan to Share IPD: No
The Cleveland Clinic
The Cleveland Clinic
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Principal Investigator: Srikanth Sola The Cleveland Clinic
The Cleveland Clinic
January 2017