Discrimination of sustained VT in structural heart disease using LGE-CMR and computational simulation: moving beyond LVEF
-
By
-
Kun Zuo
-
Kuibao Li
-
Lucheng Xu
-
Yiming Wang
-
Shiwei Lu
-
Zhaokai Kong
-
Zhenyin Fu
-
Jianjun Zhang
-
Ruiqing Dong
-
Ling Xia
-
Dongdong Deng
-
Zheng Liu
-
July 7, 2026
-
Clinical Scorecard: Differentiating Sustained Ventricular Tachycardia in Structural Heart Disease Through LGE-CMR and Computational Modeling: Advancing Beyond Left Ventricular Ejection Fraction
At a Glance
| Category | Detail |
|---|
| Condition | Sustained Ventricular Tachycardia in Structural Heart Disease |
| Key Mechanisms | Integration of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) scar characteristics with computational VT simulation. |
| Target Population | Patients with structural heart disease (SHD) undergoing LGE-CMR. |
| Care Setting | Single-centre retrospective study. |
Key Highlights
- Lower LVEF and visual LGE positivity are associated with sustained VT.
- LGE-positive patients with sustained VT have larger core scars and grey zones.
- The LGE-VTsim index effectively discriminates sustained VT beyond LVEF.
- Sustained VT is a major cause of sudden cardiac death in SHD.
- Current guidelines primarily rely on LVEF ≤ 35% for ICD therapy.
Guideline-Based Recommendations
Diagnosis
- Use LVEF and visual LGE assessment for risk stratification.
- Consider LGE-CMR for detailed characterization of arrhythmogenic substrate.
Management
- ICD implantation is recommended for patients at high risk of sudden cardiac death.
Monitoring & Follow-up
- Conduct clinical and arrhythmia assessments within 6 months post-CMR.
Risks
- A significant proportion of sudden cardiac death occurs in patients with LVEF >35%.
Patient & Prescribing Data
Patients with structural heart disease (SHD) undergoing LGE-CMR.
Guideline-directed medical therapy has reduced SCD incidence, but residual risk remains.
Clinical Best Practices
- Utilize LGE-CMR for comprehensive scar assessment.
- Incorporate computational modeling for personalized risk stratification.
Related Resources & Content
