Contrast ICE for Myocardial Scar in VT Ablations

Status Completed

Clinical Trial Summary

There is a high correlation between scar areas identified by contrast-enhanced ICE and scar areas identified by conventional electroanatomic mapping. Therefore, the investigators will assess the utility of contrast-enhanced ICE to identify and localize myocardial scar real-time during VT ablation procedures.

Clinical Trial Description

Ventricular tachycardia (VT) is a life-threatening arrhythmia which occurs frequently in the setting of structural heart disease, most often as result of myocardial fibrosis or scar. Catheter ablation is often performed to treat recurrent VT, but is predicated on precise localization of myocardial scar, as scar is often the source of VT. Currently during VT ablation procedures the identification of scar is based on electroanatomic mapping where bipolar voltage criteria have been established (i.e., bipolar electrogram voltage < 1.5 mV is considered scar). However this definition is purely based on electrical signal information and so has significant limitations: 1) there has not been definitive establishment of the sensitivity and specificity of this threshold for defining scar in comparison with tissue; 2) a detailed 3-D map created by time-consuming movement of the mapping catheter must be obtained in order to assess the existence and location of the scar; 3) only scar on the surface in contact with the mapping catheter (most often endocardial) may be definitively identified, whereas there may be intramyocardial or epicardial scar that would not be identified unless the mapping catheter makes direct contact with those areas which may involve additional risky access (epicardial) or even impossible (intramyocardial). For these reasons it would be very helpful to have another method to identify and localize myocardial scar during a VT ablation procedure. Cardiac MRI has been validated for identifying and localizing scar, but would not be recommended for many patients due to presence of ICD (implantable cardioverter-defibrillator) devices in these patients. Contrast-enhanced echocardiography has been validated to identify myocardial scar (Montant 2010), and intracardiac echocardiography (ICE) is standardly used in VT ablation procedures. Therefore, the investigators will assess the utility of contrast enhanced ICE by identifying and localizing myocardial scar real-time during VT ablation procedures. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT03212326
Study type	Interventional
Source	Weill Medical College of Cornell University
Contact
Status	Completed
Phase	N/A
Start date	March 2013
Completion date	December 2018

View Details

See also
Status	Clinical Trial	Phase
Recruiting	`NCT03453645` - Modification of Rhythmic Risk Assessment by Ventricular Tachycardia Ablation
Completed	`NCT05791032` - Sub Chronic Evaluation for ATP With an Extravascular Placed ICD Lead (STEP ICD) Study	N/A
Completed	`NCT05970120` - A Study of Intracardiac Ultrasound With the NUVISION NAV Ultrasound Catheter	N/A
Completed	`NCT04011631` - Evaluation of the iD-SystemTM, One-Handed Disposable Internal Defibrillation System.	N/A
Recruiting	`NCT03536052` - Ablation at Virtual-hEart pRedicted Targets for VT	N/A
Not yet recruiting	`NCT06063811` - Ventricular Tachycardia Ablation in LVAD Patients
Enrolling by invitation	`NCT02962076` - Study of Cardiac PET/CT Imaging to Guide Ablation Treatment of Ventricular Tachycardia	Early Phase 1
Not yet recruiting	`NCT02784912` - Biomarkers in Risk Stratification of Sustainted Ventricular Tachycardia or Electrical Storm After Ablation	N/A
Completed	`NCT01791543` - Intramural Needle Ablation for Ablation of Recurrent Ventricular Tachycardia	N/A
Terminated	`NCT02891863` - Low Energy Therapy to Convert Ventricular Tachycardias	Phase 0
Terminated	`NCT01546207` - Stepwise Approach To sUbstrate Modification for Ventricular Tachycardia	N/A
Completed	`NCT01294267` - Percutaneous Hemodynamic Support With Impella 2.5 During Scar-related Ventricular Tachycardia Ablation	N/A
Terminated	`NCT00383799` - Iv Amiodarone Versus Iv Procainamide to Treat Haemodynamically Well Tolerated Ventricular Tachycardia	Phase 4
Completed	`NCT04884100` - enHEART - Exploring Full Content of Optical Signals to Enhance Cardiac Arrhythmia Screening	N/A
Completed	`NCT04642963` - Stereotactic Management of Arrhythmia - Radiosurgery in Treatment of Ventricular Tachycardia	N/A
Recruiting	`NCT05377216` - Characterization of Cardiac Electrophysiological Effects of Autonomic Neuromodulation	Early Phase 1
Not yet recruiting	`NCT04990089` - VIVO European Observational Registry
Completed	`NCT04065893` - Impact of Catheter Ablation of Ventricular Arrhythmias on Suboptimal Biventricular Pacing in Cardiac Resynchronization Therapy
Recruiting	`NCT03631303` - Post-Extrasystolic Potentiation as a Predictor of Ventricular Arrhythmias
Recruiting	`NCT03611465` - Creation of a Pace-mapping Atlas on Healthy and Pathological Hearts	N/A