Computed Tomography-Guided Catheter Ablation for Ventricular Tachycardia

Prior treatment

• Have had a prior catheter ablation procedure for VT,

Other illness

• Active ischemia (acute thrombus diagnosed by coronary angiography, or dynamic ST segment changes demonstrated on ECG) or another reversible cause of VT (e.g. drug-induced arrhythmia), had recent acute coronary syndrome within 30 days thought to be due to acute coronary arterial thrombosis, or have CCS functional class IV angina. Note that biomarker level elevation alone after ventricular arrhythmias does not denote acute coronary syndrome or active ischemia,
• Presenting arrhythmia: polymorphic VT or ventricular fibrillation (VF),

Lab values

• Renal failure (Creatinine clearance \<30 mL/min), have NYHA Functional class IV heart failure, or a systemic illness likely to limit survival to \<1 year,

Other

• Unable to understand the nature, risks, significance and implications of the clinical investigation or unwilling to provide written informed consent,
• Are known to have protruding left ventricular thrombus or mechanical aortic and mitral valves,
• Women who are pregnant, lactating, or who are planning to become pregnant during the anticipated study period,
• Patient under legal protection

• Age ≥ 18 years,
• Indication for catheter ablation intervention with planned preoperative cardiac CT scan
• Prior myocardial infarction (using the international definition of MI: Q waves or imaging evidence of regional myocardial akinesis/thinning in the absence of a non- ischemic cause with documentation of prior ischemic injury),
• Presence of an implantable cardioverter defibrillator, or planned ID implantation before discharge, and
• One of the following monomorphic VT events within last 6 months:
  • A: ≥3 episodes of VT treated with antitachycardia pacing (ATP),
  • B: ≥1 appropriate ICD shocks,
  • C: sustained VT below detection rate of the ICD documented by ECG or any cardiac monitor
  • D: Sustained VT recorded on 12 leads ECG in the absence of ICD
• Highly effective contraception for women of childbearing potential, maintained during research procedures
• Signed informed consent ,
• Affiliated to or beneficiary of a health insurance