Transmurality mapping of left ventricular scar: impact of spatial resoluton

Introduction Left ventricular (LV) scar is associated with ventricular tachycardia (VT), related to regions of slow conduction. Endocardial LV voltage maps reveal regions of low voltage near the site of VT origin, corresponding to myocardial fiber bundles trapped in areas of extensive fibrosis. Scar transmurality (i.e. the percent of myocardial wall thickness which is scarred, measured in 6-12 sectors around the LV myocardium) is an indicator of myocardial viability after reperfusion (1). Intermediate infarct transmurality has been correlated with nonischemic VT (2). Furthermore, lower voltages are found in regions of more transmural scarring (3). We have expanded the transmurality concept to generate LGE transmurality maps of the LV.