PMID- 28120237
OWN - NLM
STAT- MEDLINE
DCOM- 20171113
LR  - 20181113
IS  - 1572-8595 (Electronic)
IS  - 1383-875X (Linking)
VI  - 48
IP  - 3
DP  - 2017 Apr
TI  - Hibernating substrate of ventricular tachycardia: a three-dimensional metabolic 
      and electro-anatomic assessment.
PG  - 247-254
LID - 10.1007/s10840-016-0219-1 [doi]
AB  - PURPOSE: Hibernating myocardium (HM) is associated with sudden cardiac death 
      (SCD). Little is known about the electrophysiological properties of HM and the 
      basis of its association with SCD. We aimed to electrophysiologically 
      characterize HM in patients with ventricular tachycardia (VT). METHODS: 
      Endocardial voltage mapping, metabolic (18)FDG-positron emission tomography (PET) 
      and perfusion (82)Rb, (201)Tl, or (99m)Tc scans were performed in 61 ischemic 
      heart disease patients with VT. Hibernating areas were identified which was 
      followed by three-dimensional PET reconstructions and integration with voltage 
      maps to allow hybrid metabolic-electro-anatomic assessment of the arrhythmogenic 
      substrate. RESULTS: Of 61 patients with ischemic heart disease and refractory VT, 
      7 were found to have hibernating myocardium (13%). A total of 303 voltage points 
      were obtained within hibernating myocardium (8.2 points per 10 cm(2)) and 
      displayed abnormal voltage in 48.5 and 78.3% of bipolar and unipolar recordings, 
      respectively, with significant heterogeneity of bipolar (p < 0.0001) and unipolar 
      voltage measurements (p = 0.0004). Hibernating areas in 6 of 7 patients contained 
      all three categories of bipolar voltage-defined scar (<0.5 mV), border zone 
      (0.5-1.5 mV), and normal myocardium (>1.5 mV). The characteristics of local 
      electrograms were also assessed and found abnormal in most recordings (76.6, 
      10.2% fractionated, 5.3% isolated potentials). Exit sites of clinical VTs were 
      determined in 6 patients, of which 3 were located within hibernating myocardium. 
      CONCLUSIONS: Hibernating myocardium displays abnormal and heterogeneous 
      electrical properties and seems to contribute to the substrate of VT. These 
      observations may underlie the vulnerability to reentry and SCD in patients with 
      hypoperfused yet viable myocardium.
FAU - Hussein, Ayman A
AU  - Hussein AA
AD  - Section of Cardiac Pacing and Electrophysiology, Cleveland Clinic, Cleveland, OH, 
      USA.
FAU - Niekoop, Michelle
AU  - Niekoop M
AD  - Division of Cardiology, University of Maryland School of Medicine, 22 S Greene 
      St, Baltimore, MD, 21201, USA.
FAU - Dilsizian, Vasken
AU  - Dilsizian V
AD  - Division of Nuclear Medicine, University of Maryland School of Medicine, 
      Baltimore, MD, USA.
FAU - Ghzally, Yousra
AU  - Ghzally Y
AD  - Division of Cardiology, University of Maryland School of Medicine, 22 S Greene 
      St, Baltimore, MD, 21201, USA.
FAU - Abdulghani, Mohammed
AU  - Abdulghani M
AD  - Division of Cardiology, University of Maryland School of Medicine, 22 S Greene 
      St, Baltimore, MD, 21201, USA.
FAU - Asoglu, Ramazan
AU  - Asoglu R
AD  - Division of Cardiology, University of Maryland School of Medicine, 22 S Greene 
      St, Baltimore, MD, 21201, USA.
FAU - Chen, Wengen
AU  - Chen W
AD  - Division of Nuclear Medicine, University of Maryland School of Medicine, 
      Baltimore, MD, USA.
FAU - Smith, Mark
AU  - Smith M
AD  - Division of Nuclear Medicine, University of Maryland School of Medicine, 
      Baltimore, MD, USA.
FAU - See, Vincent
AU  - See V
AD  - Division of Cardiology, University of Maryland School of Medicine, 22 S Greene 
      St, Baltimore, MD, 21201, USA.
FAU - Shorofsky, Stephen R
AU  - Shorofsky SR
AD  - Division of Cardiology, University of Maryland School of Medicine, 22 S Greene 
      St, Baltimore, MD, 21201, USA.
FAU - Dickfeld, Timm-Michael
AU  - Dickfeld TM
AD  - Division of Cardiology, University of Maryland School of Medicine, 22 S Greene 
      St, Baltimore, MD, 21201, USA. tdickfel@medicine.umaryland.edu.
CN  - Maryland Arrhythmia and Cardiology Imaging Group (MACIG)
LA  - eng
PT  - Journal Article
DEP - 20170125
PL  - Netherlands
TA  - J Interv Card Electrophysiol
JT  - Journal of interventional cardiac electrophysiology : an international journal of 
      arrhythmias and pacing
JID - 9708966
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
SB  - IM
MH  - Aged
MH  - Body Surface Potential Mapping/*methods
MH  - Female
MH  - Fluorodeoxyglucose F18/*pharmacokinetics
MH  - Heart Conduction System/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Imaging, Three-Dimensional/*methods
MH  - Male
MH  - Myocardial Stunning/complications/diagnostic imaging/*physiopathology
MH  - Positron-Emission Tomography/methods
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Tachycardia, Ventricular/complications/diagnostic imaging/*physiopathology
OTO - NOTNLM
OT  - Hibernating myocardium
OT  - Sudden death
OT  - Ventricular tachycardia
EDAT- 2017/01/26 06:00
MHDA- 2017/11/14 06:00
CRDT- 2017/01/26 06:00
PHST- 2016/06/07 00:00 [received]
PHST- 2016/12/14 00:00 [accepted]
PHST- 2017/01/26 06:00 [pubmed]
PHST- 2017/11/14 06:00 [medline]
PHST- 2017/01/26 06:00 [entrez]
AID - 10.1007/s10840-016-0219-1 [pii]
AID - 10.1007/s10840-016-0219-1 [doi]
PST - ppublish
SO  - J Interv Card Electrophysiol. 2017 Apr;48(3):247-254. doi: 
      10.1007/s10840-016-0219-1. Epub 2017 Jan 25.