期刊
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
卷 45, 期 4, 页码 509-518出版社
WILEY
DOI: 10.1111/pace.14456
关键词
arrhythmogenic; body surface mapping; cardiomyopathy; repolarization; right ventricular
资金
- Selanders Stiftelse
- Medtronic
- Hjart-Lungfonden [20150751]
This study explores the potential of a body surface mapping (BSM) system with 252-leads to diagnose early stages of arrhythmogenic right ventricular cardiomyopathy (ARVC) by identifying repolarization abnormalities. The results suggest that BSM may be a useful tool for identifying early manifestations of ARVC, as it detected abnormal repolarization patterns in a significant portion of healthy gene carriers.
Background: Diagnosing arrhythmogenic right ventricular cardiomyopathy (ARVC) at an early stage can be challenging even after ECG recording and a combination of several imaging techniques. The purpose of this study was to explore if a body surface mapping (BSM) system with 252-leads could identify repolarization abnormalities and thereby diagnose early stages of ARVC. Methods: ARVC patients, gene carriers without signs of ARVC and controls underwent a 12-lead resting ECG, signal-averaged ECG, echocardiography, 24-hours Holter monitoring, and BSM with electrocardiographic imaging (ECGI). All 252-leads, divided into four quadrants of the vest, were analyzed regarding concordances between T wave polarity and QRS main vector. Results: Of 40 patients included there were 12 ARVC patients, 20 gene carriers, and 8 controls. The ARVC patients had two different repolarization patterns, one with more pronounced negative T waves at the lower left panel and another with mixed changes that clearly differed from the controls, all of whom had a normal 12 lead ECGs and consistent repolarization patterns on their BSM recordings. The patterns observed in ARVC patients were also present in 5/20 (25%) gene carriers, three of whom had normal resting ECG. A novel repolarization index successfully detected all ARVC patients and 88% of gene carriers with pathologic repolarization pattern. Conclusions: The finding that abnormal repolarization patterns could be unmasked by BSM in 25% of healthy gene carriers, suggests that it may potentially be a useful tool for identifying early manifestations of ARVC. Further and larger studies are warranted to assess its diagnostic accuracy.
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