Literature DB >> 31440875

Analysis of local ventricular repolarization using unipolar recordings in patients with arrhythmogenic right ventricular cardiomyopathy.

Maciej Kubala1,2, Shuanglun Xie1, Pasquale Santangeli1, Fermin C Garcia1, Gregory E Supple1, Robert D Schaller1, Jackson J Liang1, Rajeev K Pathak1, Erica S Zado1, Cory Tschabrunn1, Jeffrey Arkles1, David J Callans1, Francis E Marchlinski3.   

Abstract

PURPOSE: In arrhythmogenic right ventricular cardiomyopathy (ARVC), abnormal electroanatomic mapping (EAM) areas are proportional to extent of T-wave inversion on 12-lead ECG. We aimed to evaluate local repolarization changes and their relationship to EAM substrate in ARVC.
METHODS: Using unipolar recordings, we analyzed the proportion of negative T waves ≥ 1 mV in depth (NegT), NegT area, Q-Tpeak (QTP), Tpeak-Tend (TPE) intervals and their relationship to bipolar (< 1.5 mV ENDO, < 1.0 mV EPI) and unipolar (< 5.5 mV) endocardial (ENDO) and epicardial (EPI) low-voltage area (LVA) in 21 pts. (15 men, mean age 39 ± 14) with ARVC. Control group included 5 pts. with normal hearts and idiopathic PVCs.
RESULTS: On ENDO, the % of NegT (7 ± 5% vs 30 ± 20%, p = 0.004) and the NegT area (12.9 ± 9.7 c m2 vs 61.4 ± 30.0 cm2, p = 0.001) were smaller in ARVC compared to controls. On EPI, the % of NegT was similar (5 ± 7% vs 3 ± 4%, p = 0.323) and the NegT area, larger (11.0 ± 8.4 cm2 vs 2.7 ± 0.9 cm2, p = 0.027) in ARVC group. In ARVC group, the % of NegT area inside LVA was larger on EPI compared to ENDO for both bipolar (81 ± 27% vs 31 ± 33%, p < 0.001) and unipolar (90 ± 19% vs 73 ± 28%, p = 0.036) recordings. Compared to normal voltage regions, QTP inside ENDO abnormal LVA was on average 58 ± 26 ms shorter and TPE, 25 ± 56 ms longer (97 ± 26 ms and 56 ± 86 ms on EPI, respectively).
CONCLUSIONS: In ARVC, NegT areas are more closely associated with abnormal depolarization LVA on the EPI and QTP is shorter and TPE longer inside ENDO and EPI abnormal LVA compared to normal voltage regions. The results add to our understanding of ARVC arrhythmia substrate.

Entities:  

Keywords:  Arrhythmogenic right ventricular cardiomyopathy; Catheter ablation; Unipolar recordings; Ventricular repolarization; Ventricular tachycardia

Year:  2019        PMID: 31440875     DOI: 10.1007/s10840-019-00594-z

Source DB:  PubMed          Journal:  J Interv Card Electrophysiol        ISSN: 1383-875X            Impact factor:   1.900


  33 in total

1.  Electrocardiographic predictors of electroanatomic scar size in arrhythmogenic right ventricular cardiomyopathy: implications for arrhythmic risk stratification.

Authors:  Alessandro Zorzi; Federico Migliore; Mohamed Elmaghawry; Maria Silvano; Martina Perazzolo Marra; Alice Niero; Kim Nguyen; Ilaria Rigato; Barbara Bauce; Cristina Basso; Gaetano Thiene; Sabino Iliceto; Domenico Corrado
Journal:  J Cardiovasc Electrophysiol       Date:  2013-09-09

2.  Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome.

Authors:  Jesus Castro Hevia; Charles Antzelevitch; Francisco Tornés Bárzaga; Margarita Dorantes Sánchez; Francisco Dorticós Balea; Roberto Zayas Molina; Miguel A Quiñones Pérez; Yanela Fayad Rodríguez
Journal:  J Am Coll Cardiol       Date:  2006-04-17       Impact factor: 24.094

3.  Brugada Syndrome Phenotype Elimination by Epicardial Substrate Ablation.

Authors:  Josep Brugada; Carlo Pappone; Antonio Berruezo; Gabriele Vicedomini; Francesco Manguso; Giuseppe Ciconte; Luigi Giannelli; Vincenzo Santinelli
Journal:  Circ Arrhythm Electrophysiol       Date:  2015-08-19

4.  Idiopathic right ventricular arrhythmias not arising from the outflow tract: prevalence, electrocardiographic characteristics, and outcome of catheter ablation.

Authors:  Hugo Van Herendael; Fermin Garcia; David Lin; Michael Riley; Rupa Bala; Joshua Cooper; Wendy Tzou; Mathew D Hutchinson; Ralph Verdino; Edward P Gerstenfeld; Sanjay Dixit; David J Callans; Cory M Tschabrunn; Erica S Zado; Francis E Marchlinski
Journal:  Heart Rhythm       Date:  2010-11-30       Impact factor: 6.343

5.  Lack of uniform progression of endocardial scar in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy and ventricular tachycardia.

Authors:  Michael P Riley; Erica Zado; Rupa Bala; David J Callans; Joshua Cooper; Sanjay Dixit; Fermin Garcia; Edward P Gerstenfeld; Mathew D Hutchinson; David Lin; Vickas Patel; Ralph Verdino; Francis E Marchlinski
Journal:  Circ Arrhythm Electrophysiol       Date:  2010-06-17

6.  Cellular basis for the Brugada syndrome and other mechanisms of arrhythmogenesis associated with ST-segment elevation.

Authors:  G X Yan; C Antzelevitch
Journal:  Circulation       Date:  1999-10-12       Impact factor: 29.690

7.  Electrocardiographic Repolarization Abnormalities and Electroanatomic Substrate in Arrhythmogenic Right Ventricular Cardiomyopathy.

Authors:  Maciej Kubala; Rajeev K Pathak; Shuanglun Xie; Ruben Casado Arroyo; Cory M Tschabrunn; Tatsuya Hayashi; Fermin C Garcia; Gregory E Supple; Pasquale Santangeli; David S Frankel; Erica S Zado; David J Callans; Francis E Marchlinski
Journal:  Circ Arrhythm Electrophysiol       Date:  2018-03

Review 8.  Substrate mapping for unstable ventricular tachycardia.

Authors:  Pasquale Santangeli; Francis E Marchlinski
Journal:  Heart Rhythm       Date:  2015-09-26       Impact factor: 6.343

Review 9.  Arrhythmogenic right ventricular cardiomyopathy.

Authors:  Cristina Basso; Domenico Corrado; Frank I Marcus; Andrea Nava; Gaetano Thiene
Journal:  Lancet       Date:  2009-04-11       Impact factor: 79.321

10.  Sequence of epicardial repolarisation and configuration of the T wave.

Authors:  J C Cowan; C J Hilton; C J Griffiths; S Tansuphaswadikul; J P Bourke; A Murray; R W Campbell
Journal:  Br Heart J       Date:  1988-11
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