Evaluation of PET/MR in Patients Selected for Ablation Therapy

Study Overview
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Brief Summary
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This study is performed to assess if PET-MR imaging can improve treatment of patients with irregular heart rate and heart failure. Heart failure occurs when the heart muscle is too weak to do his work correctly. Irregular heart rate can be related to numerous diseases. One category of irregular heart rate is called ventricular arrhythmia. It is often seen in patients who have had a heart attack. This type of arrhythmia can be dangerous and can cause sudden death. To prevent these arrhythmias, doctors can perform procedures that burn the source of arrhythmia in the heart muscle. This is called ablation. Unfortunately, ablation does not fix the problem in 100% of patients and some will still have the arrhythmia requiring repeated procedure. The purpose of this study is to find new ways of guiding the doctors performing ablation, hoping to improve the success rate of the procedure.

Official Title
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Evaluation of PET/MR in Patients Selected for Ablation Therapy

Conditions
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Arrhythmias, Cardiac

Intervention / Treatment
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* Drug: 18F-TPP


Participation Criteria
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Eligibility Criteria
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Healthy Volunteers Inclusion Criteria: Subjects must be ≥21 and ≤80 years of age; Subjects must provide informed consent prior to study procedures; Exclusion Criteria: Known structural heart disease (e.g. myocardial infarction); History of ventricular arrhythmia; Any contraindication to MRI and/or PET, including: Subjects with life vest; Subjects with implanted heart device (e.g. ICD, Pacemaker); Subjects with metallic fragment or foreign body; Subjects with other form of devices or prosthesis that are not MRI compatible, such as insulin pump, joint replacement, hearing aid, cochlear implant, permanent contraceptive devices, etc.; Claustrophobia; Relative or absolute contraindication to Dotarem contrast: history of renal disease including acute or chronic severe renal insufficiency (glomerular filtration rate <60 mL/min/1.73m2); a history of diabetes mellitus, systemic lupus, multiple myeloma, nephrogenic systemic fibrosis, and other co-morbidities; History of hypersensitive reactions to Dotarem and/or gadolinium contrast agent Any clinically significant acute or unstable physical or psychological disease, judged by the investigators based on medical history or screening physical examination, to be incompatible with the study; Any physical or psychological disease judged by the investigators to be incompatible with the study, based on medical history or screening physical examination Radiation exposure exceeds current Radiology Department guidelines (i.e. 50 mSv in the prior 12 months); Female subjects only: Positive serum and/or urine pregnancy test, or lactating, or possibility of pregnancy cannot be ruled out prior to dosing; Inability to provide written informed consent; Arrhythmia Subjects: Inclusion criteria Subjects must be ≥21 and ≤80 years of age; Subjects must provide informed consent prior to study procedures; History of scar-mediated ventricular arrhythmia scheduled for invasive EAM-guided catheter ablation for clinical care Exclusion criteria Any contraindication to MRI and/or PET, including: Subjects with life vest; Subjects with implanted heart device (e.g. ICD, Pacemaker); Subjects with metallic fragment or foreign body; Subjects with other form of devices or prosthesis that are not MRI compatible, such as insulin pump, joint replacement, hearing aid, cochlear implant, permanent contraceptive devices, etc.; Claustrophobia; Relative or absolute contraindication to Dotarem contrast: history of renal disease including acute or chronic severe renal insufficiency (glomerular filtration rate <60 mL/min/1.73m2); history of diabetes mellitus, systemic lupus, multiple myeloma, nephrogenic systemic fibrosis, and other co-morbidities; History of hypersensitive reactions to Dotarem and/or gadolinium contrast agent;Any clinically significant acute or unstable physical or psychological disease, judged by the investigators based on medical history or screening physical examination, to be incompatible with the study; Any physical or psychological disease judged by the investigators to be incompatible with the study, based on medical history or screening physical examination Radiation exposure exceeds current Radiology Department guidelines (i.e. 50 mSv in the prior 12 months); Female subjects only: Positive serum and/or urine pregnancy test, or lactating, or possibility of pregnancy cannot be ruled out prior to dosing; Inability to provide written informed consent;

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control<br>Normal subjects without history of cardiac disease or arrhythmia | Drug: 18F-TPP<br>* Imaging with 18-F-TPP (18F-BFPET)<br>* Other names: 18F-BFPET;|
| Experimental: Arrhythmia<br>This cohort consist of patients with history of recurrent VT and scheduled for EAM-guided catheter ablation as part of their clinical treatment | Drug: 18F-TPP<br>* Imaging with 18-F-TPP (18F-BFPET)<br>* Other names: 18F-BFPET;|
| Experimental: Treatment Failure<br>A subset of the Arrhythmia cohort, this group will undergo a second imaging session. This subset corresponds to patients from the Arrhythmia cohort presenting with recurrent ventricular arrhythmia following initial EAM-guided catheter ablation and requiring repeated ablation. It is estimated that 30% of the Arrhythmia cohort patients will require repeat ablation based on rate of repeat ablation procedures at MGH. T | Drug: 18F-TPP<br>* Imaging with 18-F-TPP (18F-BFPET)<br>* Other names: 18F-BFPET;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| TPP imaging in Ventricular Arrhythmia | Establish imaging patterns allowing prediction of VT ablation failure | 5 years |