Scholarlink

Background <p>Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is a severe genetic heart disease that predominantly affects young athletic individuals and carries a high risk of ventricular tachycardia (VT) and sudden cardiac death. Catheter-based radiofrequency ablation is the state-of-the-art treatment for VT; however, its effectiveness in ARVC is limited by high recurrence rates. This study aims to develop a personalized approach to improve ablation outcomes in ARVC.</p> Methods <p>We developed a non-invasive digital twin-based framework, termed GenDIRECT, that simulates cardiac electrical activity on patient-specific heart models to predict the optimal VT ablation targets. This retrospective study included 30 patients with ARVC of two common ARVC genotypes (GE and PKP2). Among them, 25 underwent a single clinical ablation, and 5 had repeat ablation within 12 months of the initial ablation. Predicted targets were compared with clinically delivered ablation lesions in patients who underwent initial and/or repeat procedures.</p> Results <p>Here, we show that <b>Gen</b>DIRECT-predicted ablation targets closely align with clinical ablation lesions (Dice score = 89.47%) in patients with successful initial procedures (<i>n</i> = 25) and are associated with significantly smaller lesion volumes (<i>p</i> = 5.39*10<sup>−5</sup>). In patients with VT recurrence requiring repeat procedures (<i>n</i> = 5), predicted targets correspond to the combined lesions from both initial and repeat ablations. <b>Gen</b>DIRECT-guided ablation targets eliminate VT inducibility in all simulations.</p> Conclusions <p><b>Gen</b>DIRECT has the potential to guide clinical VT ablation procedures in ARVC by identifying comprehensive patient-specific targets. This approach may improve procedural efficacy, reduce arrhythmia recurrence, and decrease the need for repeat ablation and subsequent hospitalizations.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Genotype-specific digital twins for arrhythmia ablation targeting in arrhythmogenic right ventricular cardiomyopathy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月20日

查看全文
  • Yingnan Zhang,
  • Adityo Prakosa,
  • Kelly Zhang,
  • Richard Carrick,
  • Jonathan Chrispin,
  • Stefan L. Zimmerman,
  • Konstantinos Aronis,
  • Eugene G. Kholmovski,
  • Crystal Tichnell,
  • Brittney Murray,
  • Cynthia James,
  • Hugh Calkins,
  • Natalia A. Trayanova

摘要

Background

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is a severe genetic heart disease that predominantly affects young athletic individuals and carries a high risk of ventricular tachycardia (VT) and sudden cardiac death. Catheter-based radiofrequency ablation is the state-of-the-art treatment for VT; however, its effectiveness in ARVC is limited by high recurrence rates. This study aims to develop a personalized approach to improve ablation outcomes in ARVC.

Methods

We developed a non-invasive digital twin-based framework, termed GenDIRECT, that simulates cardiac electrical activity on patient-specific heart models to predict the optimal VT ablation targets. This retrospective study included 30 patients with ARVC of two common ARVC genotypes (GE and PKP2). Among them, 25 underwent a single clinical ablation, and 5 had repeat ablation within 12 months of the initial ablation. Predicted targets were compared with clinically delivered ablation lesions in patients who underwent initial and/or repeat procedures.

Results

Here, we show that GenDIRECT-predicted ablation targets closely align with clinical ablation lesions (Dice score = 89.47%) in patients with successful initial procedures (n = 25) and are associated with significantly smaller lesion volumes (p = 5.39*10−5). In patients with VT recurrence requiring repeat procedures (n = 5), predicted targets correspond to the combined lesions from both initial and repeat ablations. GenDIRECT-guided ablation targets eliminate VT inducibility in all simulations.

Conclusions

GenDIRECT has the potential to guide clinical VT ablation procedures in ARVC by identifying comprehensive patient-specific targets. This approach may improve procedural efficacy, reduce arrhythmia recurrence, and decrease the need for repeat ablation and subsequent hospitalizations.