Rapid Fire Abstracts
Salman Pervaiz, MD
Clinical Research Assistant
The Ohio State University
Salman Pervaiz, MD
Clinical Research Assistant
The Ohio State University
Yu Kang, MD
Clinical Inst HS
The Ohio State University
James Whayne, MSc
Chief Clinical Officer
Myocardial Solutions, Inc.
Yuwei Wang, MD
Attending Radiologist
Taichung Veterans General Hospital, Taiwan (Republic of China)
Chong Chen, PhD
Research Scientist
The Ohio State University
Alyssa Marie Castillo, MSc
Research assistant
The Ohio State University Wexner Medical Center
Katherine Binzel, PhD
Research Scientist
The Ohio State University
Rizwan Ahmad, PhD
Associate Professor
The Ohio State University
Muhammad R. Afzal, MD
Assistant Professor
The Ohio State University
Orlando P. Simonetti, PhD
Professor
The Ohio State University
Yuchi Han, MD
Professor
The Ohio State University
Catheter ablation is the definitive treatment for patients with frequent premature ventricular contractions (PVCs) who do not respond to medical therapy. However, myocardial functional improvement after successful ablation is not well understood. Strain-encoded (SENC) imaging enables the assessment of myocardial regional function.
Methods:
Adult patients with baseline PCV burden > 9.5%, undergoing radiofrequency catheter ablation for frequent PVCs were prospectively enrolled. Cardiovascular magnetic resonance imaging (CMR) was conducted at baseline and at least 6 months after successful ablation (residual PVC burden < 5%) on a 1.5 T scanner (Sola, Siemens). SENC imaging was employed to measure global longitudinal and global circumferential strains (GLS, GCS) as well as standard deviation of time-to-peak strain of each segment (SDTTPS) on sinus beats. The mean differences between pre- and post-ablation parameters were evaluated using the Wilcoxon signed-rank test.
Results:
A total of 12 patients (mean age: 46.6±16.5 years, males: 4/33.3%) were included. After a median interval of 10.2 months (IQR 9.4-10.9 months), there was a significant reduction in left ventricular (LV) end-diastolic volume (EDV) (180.7±38.6 ml vs 159.6±31.7 ml, p=0.010), end-systolic volume (ESV) (90.7±21.3 ml vs 73.7±21.1 ml, p=0.006), and improvement in LV ejection fraction (LVEF) (51.3±5.0% vs 54.3±5.5%, p=0.045) after ablation. Figure 1 demonstrates the representative strain curves from a patient before and after ablation. There was improved longitudinal synchrony post ablation, as demonstrated by the reduction of both epicardial and mid-myocardial SDTTPS-LS (86.6±31.0 ms vs 68.5±20.1 ms, p=0.016 and 70.8±25.3 ms vs 51.4±14.5 ms, p=0.013, respectively). However, there were no significant changes in the global and segmental strain values or circumferential synchrony. Table 1 summarizes the myocardial function and strain changes post-ablation.
Conclusion: The LV global systolic function improved with improved longitudinal synchrony of the epicardial and mid-myocardial layers after successful PVC ablation. Myocardial strain magnitude or circumferential synchrony did not improve after 10 months.
