Journal Article

13. Brugada Syndrome, LQTS, and ARVC

A. Avella, E. Zachara, F. Laurenzi, A. Pappalardo, P. Di Renzi, F. Re, F. Albi, G. Messina and C. Tondo

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 7, issue s3, pages S21-S22
Published in print October 2005 | ISSN: 1099-5129
Published online October 2005 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1016/j.eupc.2005.08.172
13. Brugada Syndrome, LQTS, and ARVC

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Background

Electroanatomic (EA) voltage mapping of the right ventricle (RV) by CARTO System has recently been proposed as a new diagnostic tool to identify dysplastic regions in patients affected with arrhythmogenic right ventricular cardiomyopathy (ARVC). Three-dimensional reconstruction of endocavitary electrogram distribution, performed by CARTO System, would allow the identification of RV low voltage areas, reflecting fibrofatty myocardial replacement. The purpose of our study was to compare EA voltage mapping during sinus rhythm with RV non-invasive assessment in ARVC patients.

Methods

we enrolled ten consecutive patients fulfilling standardized diagnostic criteria for ARVC (age range: 28-46 years, 5 males), with indication to electrophysiological test to evaluate ventricular electrical vulnerability or to validate an empirically selected antiarrhythmic treatment. After an integrated ECHO + MRI evaluation, an invasive EA reconstruction of RV was performed sampling multiple endocardial sites (202 ± 61) during sinus rhythm. Voltage map analysis was performed with a 0.5-1.5 mV colour range setting of voltage display.

Results

in all patients voltage mapping documented very low voltage areas (</= 0.5 mV) consisting with transmural fibrofatty replacement. Voltage analysis demonstrated in all patients different degrees of involvement of RV segments and a marked dispersion of amplitude and duration values (unipolar and bipolar). Analysis of EA distribution of low voltage areas documented a greater involvement of outflow and inflow tracts compared with RV apex and evidenced a lesser involvement of septal wall compared with free wall. In all patients concordance was noted between EA mapping results and non-invasive morphological-functional RV evaluation.

Conclusions

voltage mapping appears to be a promising method to study ARVC.

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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