Can Fat Deposition After Myocardial Infarction Alter the Performance of RF Catheter Ablation of Scar-Related Ventricular Tachycardia?: Results from a Computer Modeling Study

J Cardiovasc Electrophysiol. 2016 Aug;27(8):947-52. doi: 10.1111/jce.13006. Epub 2016 Jun 14.

Abstract

Introduction: The outcomes of catheter ablation of scar-mediated ventricular tachycardia (VT) remain far from perfect. The presence of fat as a component of the underlying substrate for scar-mediated VT could be relevant since this entity can seriously impede the passage of RF current due to its low electrical conductivity.

Methods and results: Computer models of RF ablation were built in order to investigate the means by which the spatial heterogeneity of different tissues represented within the ventricular infarct zone, including the viable myocardium, fibrous tissue, and fat, could influence temperature distributions during RF ablation. The results demonstrated that spatial distributions of different tissue types significantly alter the density of electrical current largely as a result of fat impeding the passage of current. However, the thermal lesions appear minimally unaffected by this phenomenon, with variations in depth of ∼1 mm.

Conclusion: While during RF ablation of scar-related ventricular tachycardia differences in tissue characteristics may affect the density of electrical current on a small-scale, overall this does not appear to significantly impact the size of the created thermal lesions.

Keywords: RF ablation; computer model; fat deposition; myocardial infarction; scar-related ventricular tachycardia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Action Potentials
  • Adipose Tissue / pathology*
  • Adipose Tissue / physiopathology
  • Catheter Ablation*
  • Cicatrix / etiology*
  • Cicatrix / pathology
  • Cicatrix / physiopathology
  • Computer Simulation
  • Electric Conductivity
  • Fibrosis
  • Heart Rate
  • Humans
  • Models, Cardiovascular*
  • Myocardial Infarction / complications*
  • Myocardial Infarction / pathology
  • Myocardial Infarction / physiopathology
  • Myocardium / pathology*
  • Tachycardia, Ventricular / etiology
  • Tachycardia, Ventricular / pathology
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / surgery*
  • Time Factors
  • Treatment Outcome