BACKGROUND: Islets of myocytes within fibrofatty scars represent the substrate for reentrant ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC). Electroanatomic mapping can reliably identify such areas. OBJECTIVE: To prospectively test the association between late and fragmented electrograms within scar and arrhythmic events in patients with ARVC. METHODS: High-density right ventricle electroanatomic mapping was performed in 32 patients with ARVC without history of cardiac arrest or sustained ventricular arrhythmias. Standard definitions of electroanatomic scars and fragmented, isolated, and very late potentials were used. All patients received an implantable cardioverter-defibrillator for the primary prevention of sudden death. RESULTS: After a mean follow-up of 25 ± 7 months, 12 (38%) patients received appropriate implantable cardioverter-defibrillator shock for sustained ventricular arrhythmias. With the exception of a higher rate of previous syncope (P = .053), patients with arrhythmic events at follow-up did not differ from those who remained free from arrhythmic events in terms of other clinical variables, including cardiac magnetic resonance findings. Electroanatomic scars were present in all patients. The distribution and extent of electroanatomic scars were similar in the 2 groups (38 ± 25 cm(2) vs 33 ± 20 cm(2); P = .51). However, patients with implantable cardioverter-defibrillator shock had a higher prevalence of fragmented electrograms (92% vs 20%; P <.001), of isolated late potentials (75% vs 20%; P = .004), and of very late potentials (67% vs 25%; P = .030). Fragmented electrograms were the only variable independently associated with arrhythmic events at follow-up (hazard ratio 21; P = .015). CONCLUSION: The presence of fragmented and delayed electrograms within the scar predicts arrhythmic events in ARVC.
BACKGROUND: Islets of myocytes within fibrofatty scars represent the substrate for reentrant ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC). Electroanatomic mapping can reliably identify such areas. OBJECTIVE: To prospectively test the association between late and fragmented electrograms within scar and arrhythmic events in patients with ARVC. METHODS: High-density right ventricle electroanatomic mapping was performed in 32 patients with ARVC without history of cardiac arrest or sustained ventricular arrhythmias. Standard definitions of electroanatomic scars and fragmented, isolated, and very late potentials were used. All patients received an implantable cardioverter-defibrillator for the primary prevention of sudden death. RESULTS: After a mean follow-up of 25 ± 7 months, 12 (38%) patients received appropriate implantable cardioverter-defibrillator shock for sustained ventricular arrhythmias. With the exception of a higher rate of previous syncope (P = .053), patients with arrhythmic events at follow-up did not differ from those who remained free from arrhythmic events in terms of other clinical variables, including cardiac magnetic resonance findings. Electroanatomic scars were present in all patients. The distribution and extent of electroanatomic scars were similar in the 2 groups (38 ± 25 cm(2) vs 33 ± 20 cm(2); P = .51). However, patients with implantable cardioverter-defibrillator shock had a higher prevalence of fragmented electrograms (92% vs 20%; P <.001), of isolated late potentials (75% vs 20%; P = .004), and of very late potentials (67% vs 25%; P = .030). Fragmented electrograms were the only variable independently associated with arrhythmic events at follow-up (hazard ratio 21; P = .015). CONCLUSION: The presence of fragmented and delayed electrograms within the scar predicts arrhythmic events in ARVC.
Authors: Domenico Corrado; Peter J van Tintelen; William J McKenna; Richard N W Hauer; Aris Anastastakis; Angeliki Asimaki; Cristina Basso; Barbara Bauce; Corinna Brunckhorst; Chiara Bucciarelli-Ducci; Firat Duru; Perry Elliott; Robert M Hamilton; Kristina H Haugaa; Cynthia A James; Daniel Judge; Mark S Link; Francis E Marchlinski; Andrea Mazzanti; Luisa Mestroni; Antonis Pantazis; Antonio Pelliccia; Martina Perazzolo Marra; Kalliopi Pilichou; Pyotr G A Platonov; Alexandros Protonotarios; Alessandra Rampazzo; Jeffry E Saffitz; Ardan M Saguner; Christian Schmied; Sanjay Sharma; Hari Tandri; Anneline S J M Te Riele; Gaetano Thiene; Adalena Tsatsopoulou; Wojciech Zareba; Alessandro Zorzi; Thomas Wichter; Frank I Marcus; Hugh Calkins Journal: Eur Heart J Date: 2020-04-07 Impact factor: 29.983
Authors: Paloma Jordà; Laurens P Bosman; Alessio Gasperetti; Andrea Mazzanti; Jean Baptiste Gourraud; Brianna Davies; Tanja Charlotte Frederiksen; Zoraida Moreno Weidmann; Andrea Di Marco; Jason D Roberts; Ciorsti MacIntyre; Colette Seifer; Antoine Delinière; Wael Alqarawi; Deni Kukavica; Damien Minois; Alessandro Trancuccio; Marine Arnaud; Mattia Targetti; Annamaria Martino; Giada Oliviero; Daniel C Pipilas; Corrado Carbucicchio; Paolo Compagnucci; Antonio Dello Russo; Iacopo Olivotto; Leonardo Calò; Steven A Lubitz; Michael J Cutler; Philippe Chevalier; Elena Arbelo; Silvia Giuliana Priori; Jeffrey S Healey; Hugh Calkins; Michela Casella; Henrik Kjærulf Jensen; Claudio Tondo; Rafik Tadros; Cynthia A James; Andrew D Krahn; Julia Cadrin-Tourigny Journal: Eur Heart J Date: 2022-08-21 Impact factor: 35.855
Authors: Yuki Komatsu; Amir Jadidi; Frederic Sacher; Arnaud Denis; Matthew Daly; Nicolas Derval; Ashok Shah; Heiko Lehrmann; Chan-Il Park; Reinhold Weber; Thomas Arentz; Gregor Pache; Maxime Sermesant; Nicholas Ayache; Jatin Relan; Michel Montaudon; François Laurent; Mélèze Hocini; Michel Haïssaguerre; Pierre Jaïs; Hubert Cochet Journal: J Am Heart Assoc Date: 2014-08-07 Impact factor: 5.501
Authors: Domenico Corrado; Thomas Wichter; Mark S Link; Richard N W Hauer; Frank E Marchlinski; Aris Anastasakis; Barbara Bauce; Cristina Basso; Corinna Brunckhorst; Adalena Tsatsopoulou; Harikrishna Tandri; Matthias Paul; Christian Schmied; Antonio Pelliccia; Firat Duru; Nikos Protonotarios; Na Mark Estes; William J McKenna; Gaetano Thiene; Frank I Marcus; Hugh Calkins Journal: Circulation Date: 2015-07-27 Impact factor: 29.690
Authors: Domenico Corrado; Thomas Wichter; Mark S Link; Richard Hauer; Frank Marchlinski; Aris Anastasakis; Barbara Bauce; Cristina Basso; Corinna Brunckhorst; Adalena Tsatsopoulou; Harikrishna Tandri; Matthias Paul; Christian Schmied; Antonio Pelliccia; Firat Duru; Nikos Protonotarios; N A Mark Estes; William J McKenna; Gaetano Thiene; Frank I Marcus; Hugh Calkins Journal: Eur Heart J Date: 2015-07-27 Impact factor: 29.983