Prediction of Location of Late Potentials for Ventricular Tachycardia Ablation with 99mTcMIBI Scintigram Scar

• Project/Area Number: 18K15546
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Osaka University
• Principal Investigator: Kentaro Ozu 大阪大学, 医学部附属病院, 医員 (10650088)
• Project Period (FY): 2018-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000); Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2018: ¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000)
• Keywords: 99mTcMIBI心筋シンチグラフィ / 心室頻拍 / カテーテル心筋焼灼術 / 99mTcシンチグラフィ / 遅延電位 / カテ―テル心筋焼灼術 / 99mTcMIBIシンチグラフィ

Outline of Final Research Achievements

We evaluated that the uptake rate of 99mTcMIBI scintigram could predict the location of late potentials (LPs) which were the targets of the radiofrequency ablation for ventricular tachycardia (VT). In 7 patients with ischemic cardiomyopathy (ICM) and VT, electroanatomical map and scintigraphic image of left ventricular were obtained and were divided into twenty segments. The relation between LPs and scintigrafic characteristics were evaluated in total of 140 segments. LPs were recorded in 54 segments. According to the 99mTc uptake rate, cut off value 35% was set for the prediction of the distribution of LPs with ROC curve (area under the curve 0.89). LPs were observed in the lower scintigram perfusion segments with <35% uptake rate with statistical significance (sensitivity 81%, specificity 87%). Lower perfusion area of 99mTcMIBI scintigram could be utilized to predict VT substrate location in ICM cases. However, there was no significance for prediction of LPs location in nonICM cases.

Academic Significance and Societal Importance of the Research Achievements

低左心機能症例に合併することが多い心室頻拍に対し、心室頻拍のカテーテル心筋焼灼術は円滑に行われることが望ましく、ターゲットとする遅延電位の局在を術前に確認できる方法が存在することが重要である。傷害心筋内に存在する心室頻拍の不整脈基質の予測性を示唆されている造影MRIや造影CTを用いることが困難なICD等植込みデバイス装着例や腎機能低下例、重度心機能低下例において、99mTcMIBIシンチグラフィでのviability低下領域を評価することで、心室頻拍の不整脈基質の局在を予測し、円滑なカテーテル心筋焼灼術の施行が可能となりうるものと考える。

Research Products

• [Presentation] Prediction of Location of Late Potentials for Ventricular Tachycardia Ablation with Tc-99m Scintigram Scar (2020)
  • Author(s): Kentaro Ozu, Hitoshi Minamiguchi, Tomoaki Nakano, Akihiro Sunaga, Hiroya Mizuno, Yasushi Sakata
  • Organizer: the 2020 Heart Rhythm Scientific Sessions
  • Int'l Joint Research
• [Presentation] Prediction of Distribution of Late Potentials for Ventricular Tachycardia Ablation with Tc-99m Scintigram Scar (2019)
  • Author(s): Kentaro Ozu, Hitoshi Minamiguchi, Tomoaki Nakano, Akihiro Sunaga, Isamu Mizote, Hiroya Mizuno, Shungo Hikoso, Yasushi Sakata
  • Organizer: the 12th Asia Pacific Heart Rhythm Scientific Session YIA Session
  • Int'l Joint Research
• [Presentation] Prediction of Late Potentials for Ventricular Tachycardia Ablation with Tc-99m Scintigram Scar (2018)
  • Author(s): Kentaro Ozu, Hitoshi Minamiguchi, Hiroya Mizuno, Shungo Hikoso, Yasushi Sakata
  • Organizer: 第65回日本不整脈心電学会学術大会
• [Presentation] Prediction of the distribution of local abnormal vetricularactivities for ventricular tachycardia ablation with Tc-99m scintigram (2018)
  • Author(s): Kentaro Ozu, Hitoshi Minamiguchi, Shozo Konishi, Isamu Mizote, Hiroya Mizuno, Shungo Hikoso, Yasushi Sakata
  • Organizer: ESC Congress 2018
  • Int'l Joint Research