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Erschienen in: Pediatric Cardiology 4/2019

06.03.2019 | Original Article

Computational Identification of Ventricular Arrhythmia Risk in Pediatric Myocarditis

verfasst von: Mark J. Cartoski, Plamen P. Nikolov, Adityo Prakosa, Patrick M. Boyle, Philip J. Spevak, Natalia A. Trayanova

Erschienen in: Pediatric Cardiology | Ausgabe 4/2019

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Abstract

Children with myocarditis have increased risk of ventricular tachycardia (VT) due to myocardial inflammation and remodeling. There is currently no accepted method for VT risk stratification in this population. We hypothesized that personalized models developed from cardiac late gadolinium enhancement magnetic resonance imaging (LGE-MRI) could determine VT risk in patients with myocarditis using a previously-validated protocol. Personalized three-dimensional computational cardiac models were reconstructed from LGE-MRI scans of 12 patients diagnosed with myocarditis. Four patients with clinical VT and eight patients without VT were included in this retrospective analysis. In each model, we incorporated a personalized spatial distribution of fibrosis and myocardial fiber orientations. Then, VT inducibility was assessed in each model by pacing rapidly from 26 sites distributed throughout both ventricles. Sustained reentrant VT was induced from multiple pacing sites in all patients with clinical VT. In the eight patients without clinical VT, we were unable to induce sustained reentry in our simulations using rapid ventricular pacing. Application of our non-invasive approach in children with myocarditis has the potential to correctly identify those at risk for developing VT.
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Metadaten
Titel
Computational Identification of Ventricular Arrhythmia Risk in Pediatric Myocarditis
verfasst von
Mark J. Cartoski
Plamen P. Nikolov
Adityo Prakosa
Patrick M. Boyle
Philip J. Spevak
Natalia A. Trayanova
Publikationsdatum
06.03.2019
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 4/2019
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-019-02082-7

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