Myocardial Infarction Clinical Trial
Official title:
Impedance Measurement of Epicardial Substrate for Ventricular Arrhythmias: Case Control Series of Patients With and Without Myocardial Scarring
This is a research study to evaluate the electrical properties of heart tissue. The purpose of this study is to determine the impedance (electrical resistance) of different tissues on the outer surface of the heart. This may be important for distinguishing scarred heart muscle from fat that can be seen on the surface of the heart. This information may eventually be utilized in patients that undergo a procedure (called catheter ablation) for the treatment of life-threatening heart rhythms. Investigators expect a detectable difference between the impedance of normal and infarcted myocardium (approximately 50 ohms).
The treatment of cardiac arrhythmias with endocardial catheter ablation has evolved rapidly
over the past few decades. At the time of this writing, the ablation of almost all atrial
and ventricular arrhythmias has been described in the literature. Multiple energy modalities
(e.g. radiofrequency, cryotherapy) and approaches (e.g. retrograde aortic, transseptal
puncture) have been described, yet ablation of some rhythms is not as successful as others.
The realization that ventricular tachycardia (VT) in the setting of Chagas Disease can
originate in the epicardium has lead to the development of a percutaneous, transthoracic
epicardial approach to mapping and ablation of this arrhythmia. This approach has now been
applied to patients with VT in the setting of ischemic and nonischemic heart disease at many
centers throughout the world. Traditional mapping technologies are utilized on the
epicardium to define scarred heart tissue and locate the VT circuit.
It is well known that human hearts display a variable amount of fat overlying the
epicardium. Not only is the coronary vasculature embedded in a layer of adipose tissue, but
the rest of the heart may have areas of epicardial fat. As fat is an insulator and does not
generate or easily conduct electrical activity, current mapping techniques may classify
epicardial fat incorrectly as myocardial scar. This may have important effects on the
ability to diagnose and treat arrhythmias with epicardial ablation.
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Observational Model: Cohort, Time Perspective: Prospective
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