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

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.