Grant: Project Grant

Ventricular tachycardia (VT), a fast heart rhythm, is a common and potentially lethal complication in patients who suffer a heart attack (i.e., infarct) and later develop chronic scars. The current diagnostic procedures are highly invasive, precluding many patients to undergo the VT inducibility test in the electrophysiology (EP) lab and often failing to detect the VT foci in those undergoing the test. Furthermore, radio-frequency ablation (RFA) therapy has a low success in scar-related VT patients. Thus, there is a clear need to develop better tools that can help clinicians to effectively improve the diagnostic procedure and the treatment success (i.e., destruction of foci). While recent research efforts from our group have been focused on employing exquisite MR imaging methods to identify the structural hallmarks of these foci, here we propose an innovative complementary approach by developing computer heart models that offer a comprehensive '3D look into the heart' and allow us to non-invasively predict using simulations the electrical impulse propagation in the presence of scars. Our focus is to customize preclinical heart models using high resolution MR images and electrical data obtained in vivo in a translational pig model of chronic infarct. Specifically, we will aim to: 1) develop a novel minimally invasive technology able to accurately simulate in silico the typical clinical VT test; and 2) determine via simulations the critical sites for RFA, thereby informing the operator where precisely to place the ablation lesions to achieve a complete destruction of suspected foci and a higher success rate of RFA. We envision that these personalized MRI-based heart models will hold the unique capability to simplify highly invasive EP studies, predict the VT inducibility and precisely guide the therapy, leading to a substantially improved VT treatment outcome and, ultimately, to a higher quality of life in a large population of Canadian patients with scar-related VT.