Lipomatous metaplasia as the most reliable computed tomography predictor for functional substrate localization in scar-related ventricular tachycardia.

Catheter ablation is an effective treatment of ventricular arrhythmias in patients with structural heart disease, particularly when electroanatomic mapping (EAM) is integrated with data from late gadolinium enhancement cardiac magnetic resonance imaging. Cardiac computed tomography (CT) helps with indirect ventricular tachycardia (VT) substrate identification through analysis of left ventricular (LV) wall thickness. 1 Takigawa M. Duchateau J. Sacher F. et al. Are wall thickness channels defined by computed tomography predictive of isthmuses of postinfarction ventricular tachycardia?. Heart Rhythm. 2019; 16: 1661-1668 Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar Intramyocardial lipomatous metaplasia (LM) plays a significant role in arrhythmogenesis and VT facilitation. 2 Xu L. Zahid S. Khoshknab M. et al. Lipomatous metaplasia prolongs repolarization and increases repolarization dispersion within post-infarct ventricular tachycardia circuit cites. Europace. 2023; 25: 496-505 Crossref PubMed Scopus (3) Google Scholar The purpose of this study was to investigate LM performance in functional substrate localization in patients with scar-related VT. The study was approved by the local ethical committee.