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PET/MR Mapping of Myocardial Membrane Potential


The current state-of-the-art technique for ventricular tachycardia (VT) ablation utilizes electroanatomic mapping (EAM) and site-specific electrograms to guide delivery of ablation lesions. Although EAM can assist in distinguishing viable tissue from scar in infarcted areas, it does not represent a true gold standard for differentiating scar from viable or healthy myocardium. The limitations of EAM are reflected in the frequent recurrences (~30%) of VT after ablation. The basic insight of this proposal is that 3D imaging of mitochondrial membrane potential (MP) and the size of the extracellular space (ECS) provides a more comprehensive assessment of the arrhythmogenic substrate than EAM. We propose PET/MRI to map both mitochondrial MP and ECS for use in the detection of left ventricular (LV) scar. Our approach provides a full 3D map of myocardial membrane potential, in contrast to the 1-2mm depth beneath the endo- and epicardial surfaces afforded by EAM. The method is noninvasive and well suited to clinical translation for study of a variety of diseases, including ventricular arrhythmias, cardiomyopathy, hypertrophy, skeletal muscle disorders, etc.

Funded by the NIH National Center for Advancing Translational Sciences through its Clinical and Translational Science Awards Program, grant number UL1TR002541.