# Peri-procedural transmural electrophysiological imaging of scar-related ventricular tachycardia

> **NIH NIH R01** · ROCHESTER INSTITUTE OF TECHNOLOGY · 2021 · $627,240

## Abstract

Project Summary
Ventricular tachycardia (VT) is an important cause of mortality and morbidity in patients with heart diseases.
The majority of life-threatening VT episodes are caused by an electrical "short circuit", formed by a narrow
channel of surviving tissue inside myocardial scar. An important treatment for scar-related VT is to target and
destroy these culprit slow-conducting channels. Effective ablation requires the ability to delineate the
morphology of the circuit in order to identify the slow-conducting channels. Unfortunately, with conventional
catheter mapping, up to 90% of the VT circuits are too short-lived to be mapped. For the 10% “mappable” VTs,
their data are available only during ablation and limited to one ventricular surface. This inadequacy of
functional VT data largely limits our current knowledge about scar-related VT and ablation strategies, and
reduces the ability of clinicians to identify ablation targets and assess ablation outcome. The goal of this
proposal is to develop a novel technique to provide pre- and post-ablation functional VT data – integrated with
LGE-MRI scar data in 3D – to improve VT ablation with pre-procedural identification of ablation targets and
post-procedural mechanistic elucidation of ablation failure. It builds on the rapidly increasing clinical interest in
electrocardiographic imaging (ECGi), an emerging technique that obtains cardiac electrical activity through
inverse reconstructions from body-surface ECGs. Its specific objectives include:
 1) To develop and validate a peri-procedural ECGi for mapping scar-related VT circuits.
 2) To integrate LGE-MRI scar into ECGi for improved electroanatomical investigations of VT circuits.
 3) To perform clinical evaluation of pre-ablation and post-ablation MRI-ECGi of scar-related VT.
These investigations will be carried out on a prospective cohort of 40 patients with VT due to previous
infarction. This research builds on our previously established technical foundation for transmural ECGi and
promising preliminary data generated under the support of our exploratory NIH grant. It is further supported by
previous technical and clinical advances in each of the subcontractors' lab, including camera-based torso
modeling (Siemens), intramural mapping and ablation (NSHA), and LGE-MRI scar imaging in VT (UPenn). The
outcome of this research will generate new knowledge about the electroanatomical mechanism of scar-related
VT and the mechanism behind ablation failure. It will enable pre- and post-procedural mapping of 3D functional
circuits of all inducible VTs, improving the ability of clinicians to identify ablation targets and assess ablation
outcome. Finally, it will timely deliver the next generation of ECGi techniques to further our general technical
capability for safer and more efficient cardiac electrophysiological studies in a broader variety of heart
diseases.

## Key facts

- **NIH application ID:** 10086878
- **Project number:** 5R01HL145590-03
- **Recipient organization:** ROCHESTER INSTITUTE OF TECHNOLOGY
- **Principal Investigator:** Linwei Wang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $627,240
- **Award type:** 5
- **Project period:** 2019-02-08 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10086878

## Citation

> US National Institutes of Health, RePORTER application 10086878, Peri-procedural transmural electrophysiological imaging of scar-related ventricular tachycardia (5R01HL145590-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10086878. Licensed CC0.

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