Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia
Laredo, Mikael; Tovia-Brodie, Oholi; Milman, Anat; Michowitz, Yoav; Roudijk, Rob W; Peretto, Giovanni; Badenco, Nicolas; Te Riele, Anneline S J M; Sala, Simone; Duthoit, Guillaume; Arbelo, Elena; Ninni, Sandro; Gasperetti, Alessio; van Tintelen, J Peter; Paglino, Gabriele; Waintraub, Xavier; Andorin, Antoine; Peichl, Petr; Bosman, Laurens P; Calo, Leonardo; Giustetto, Carla; Radinovic, Andrea; Jorda, Paloma; Casado-Arroyo, Ruben; Zorio, Esther; Bermúdez-Jiménez, Francisco J; Behr, Elijah R; Havranek, Stepan; Tfelt-Hansen, Jacob; Sacher, Frederic; Hermida, Jean-Sylvain; Nof, Eyal; Casella, Michela; Kautzner, Josef; Lacroix, Dominique; Brugada, Josep; Duru, Firat; Bella, Paolo Della; Gandjbakhch, Estelle; Hauer, Richard; Belhassen, Bernard
(2023) Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, volume 25, issue 3, pp. 1025 - 1034
(Article)
Abstract
Aims Little is known about patients with right bundle branch block (RBBB)-ventricular tachycardia (VT) and arrhythmogenic cardiomyopathy (ACM). Our aims were: (i) to describe electrocardiogram (ECG) characteristics of sinus rhythm (SR) and VT; (ii) to correlate SR with RBBB-VT ECGs; and (iii) to compare VT ECGs with electro-anatomic mapping (EAM)
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data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Methods From the European Survey on ACM, 70 patients with spontaneous RBBB-VT were included. Putative left ventricular (LV) and results sites of origin (SOOs) were estimated with a VT-axis-derived methodology and confirmed by EAM data when available. Overall, 49 (70%) patients met definite Task Force Criteria. Low QRS voltage predominated in lateral leads (n = 37, 55%), but QRS fragmentation was more frequent in inferior leads (n = 15, 23%). frequent in inferior (n = 28, 42%) and lateral (n = 27, 40%) leads. TWI in inferior leads was associated with reduced LV ejection fraction (LVEF; 46 ± 10 vs. 53 ± 8, P = 0.02). Regarding SOOs, the inferior wall harboured 31 (46%) SOOs, followed by the lateral wall (n = 17, 25%), the anterior wall (n = 15, 22%), and the septum (n = 4, 6%). EAM data were available for 16 patients and showed good concordance with the putative SOOs. In all patients with superior-axis RBBB-VT who underwent endo-epicardial VT activation mapping, VT originated from the LV. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusions In patients with ACM and RBBB-VT, RBBB-VTs originated mainly from the inferior and lateral LV walls. SR depolarization and repolarization abnormalities were frequent and associated with underlying variants.
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Keywords: Arrhythmogenic cardiomyopathy, Arrhythmogenic right ventricular cardiomyopathy, ECG, Site of origin, Ventricular arrhythmia, Cardiology and Cardiovascular Medicine, Physiology (medical), Journal Article
ISSN: 1099-5129
Publisher: Oxford University Press
Note: Publisher Copyright: © 2023 Oxford University Press. All rights reserved.
(Peer reviewed)
