Akademik Veri Yönetim Sistemi
Journal of Interventional Cardiac Electrophysiology, 2026 (SCI-Expanded, Scopus)
Background: Functional mapping tools such as Coherent Mapping (CM) and Isochronal Late Activation Mapping (ILAM) allow visualization of conduction slowing and block during ventricular tachycardia (VT) ablation; however, their anatomical correlates within computed tomography (CT)–derived myocardial wall-thickness (WT) maps are incompletely defined. We aimed to evaluate the spatial relationship between CT-derived WT characteristics and functional electroanatomical markers and to assess the predictive value of WT-derived conduction channels (WTC) for identifying critical VT isthmuses. Methods: Seven consecutive patients with ischemic cardiomyopathy undergoing VT ablation and pre-procedural contrast-enhanced CT were analyzed. WT maps and WTCs were reconstructed using the inHeart™ platform and integrated with CARTO 3 electroanatomical maps. CM-SCZs, ILAM-DZs, and lines of blocks (LOBs) were identified using predefined criteria and projected onto WT models. Local WT values, overlap with WT ≤ 5 mm regions, and Dice similarity coefficients were calculated to quantify anatomical–functional concordance. Results: Eighteen CM-SCZs, 15 ILAM-DZs, and 12 LOBs were identified. Functional regions predominantly localized within thinned myocardium (WT ≤ 5 mm). Mean WT was 3.6 ± 0.8 mm for SCZs, 3.8 ± 0.9 mm for DZs, and 4.2 ± 1.1 mm for LOBs, compared with 6.3 ± 1.3 mm in remote myocardium (p < 0.01). SCZs overlapped with WT ≤ 5 mm areas by 74 ± 12% (Dice 0.67 ± 0.10), while DZs showed 70 ± 15% overlap (Dice 0.63 ± 0.11). Direct correspondence between WTCs and SCZs occurred in 50% of cases. Conclusions: Although CT-derived WTCs identify regions at risk, functional mapping remains essential for precise substrate delineation. Integrated CT and CM/ILAM analysis may enhance targeting efficiency during VT ablation.