Reply to letter to the editor: '2D LGE or 3D high-resolution LGE: Role of cardiovascular magnetic resonance imaging in the treatment of ventricular arrhythmias'

Abstract

We are pleased that our paper raised interest among readers of the Anatolian Journal of Cardiology. Even though the late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging was first established for ventricular tissue characterization in localizing ventricular tachycardia (VT) ablation targets (CMR-aided), it is by now widely used as a clinical tool to guide VT ablation (CMR-guided) through the detection of the arrhythmogenic substrate and conducting channels. While the CMR-derived information has been used alongside electroanatomic mapping (EAM) data to aid VT ablation (CMR-aided), the CMR-guided approaches, where EAM acquisition is completely avoided, make procedures faster, and the operator relies solely on imaging data.1 As the authors reported, the analysis of CMR images with software, which is known as ADAS (ADAS 3D, Barcelona, Spain), is very helpful for identifying these conducting channels.2 The preliminary results showed that the mean procedure duration was lower in CMR-guided when compared to CMR-aided and No-CMR substrate ablation (109 ± 61 vs. 206 ± 70 and 233 ± 48 minutes, respectively; P <.001 for both comparisons).1 VOYAGE is a prospective, randomized, multicenter controlled open-label study designed to compare in terms of efficacy, efficiency, and safety of a CMR-aided or guided workflow to standard EAM-guided VT ablation.