Ablation at Virtual-hEart pRedicted Targets for VT

Study Overview
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Brief Summary
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The goal of this study is to test the efficacy of the new imaging/simulation (virtual heart) approach for determining the optimal ablation sites in patients with VT, which render post-infarction VT non-inducible. The study will test both the acute outcome of the ablation procedure, and the effect the use of the predicted targets has upon procedure time.

Official Title
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Ablation at Virtual-hEart pRedicted Targets for VT

Conditions
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Ventricular Tachycardia, Ischemic Cardiomyopathy

Intervention / Treatment
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* Device: Virtual Heart Guided Ablation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Eligible patients must be at least 18 years old at the time of enrollment. A Pre-Op cardiac MRI including late gadolinium enhancement (LGE) must be performed prior to ablation. As Johns Hopkins University (JHU) performs MRIs with implantable cardioverter defibrillator (ICD) or pacemaker implanted, patients with these devices may be enrolled. Eligible patients must suffer from VT, thought to be secondary to structural heart disease (scarring). Eligible patients must be determined to be suitable candidates for ablation to treat VT by their cardiologist and/or electrophysiologists regardless of this protocol. Exclusion Criteria: Patients with Glomerular Filtration Rate (GFR) < 30 mL/min should not be enrolled in the study due to the use of intravenous gadolinium as an MRI contrast agent If a pre-procedure MRI cannot or likely will not be performed for any reason (such as claustrophobia), the patient must be excluded. Pregnant women may not participate in the study because gadolinium MRI contrast is contraindicated in these patients. Any subject that, during the course of the pre-procedure imaging, is discovered to have VT not related to scarring, he/she must be de-enrolled from the study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Virtual Heart Guided Ablation<br> | Device: Virtual Heart Guided Ablation<br>* If a good quality cardiac MRI is obtained and a virtual heart model with the ablation targets is generated, the operating physician will merge the virtual heart lesion map to the invasive electroanatomical navigation system. After the patient has been catheterized, an attempt should be made to induce VT. The physician should then navigate the catheter to each of the ablation targets specified, and place a lesion as per his or her training and experience, confirming when done that the lesion marker in the mapping system coincides with the target. This will be done for each lesion.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ventricular Tachycardia Inducibility | Following ablation, inducibility of VT will be determined using programmed electrical stimulation | time of procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Freedom from Ventricular Tachycardia | Long term Freedom of Spontaneous Ventricular Tachycardia | 1 year |