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High‐Resolution 3D Scar Imaging Using a Novel Late Iodine Enhancement Multidetector CT Protocol to Guide Ventricular Tachycardia Catheter Ablation

Scar delineation with late gadolinium‐enhanced MRI can direct VT substrate mapping and ablation, but imaging is poor and relatively contraindicated in the majority of patients with ICDs. We present a case of scar definition using late iodine‐enhanced multidetector CT in a patient with ischemic cardiomyopathy and multiple ICD shocks for VT. CT images were acquired using a novel intracoronary contrast delivery protocol which provided high‐resolution subendocardial scar visualization. The segmented scar images were subsequently imported into an electroanatomic mapping platform to guide successful VT ablation.