• Something wrong with this record ?

Electroanatomical Voltage Mapping to Distinguish Right-Sided Cardiac Sarcoidosis From Arrhythmogenic Right Ventricular Cardiomyopathy

JC. Hoogendoorn, M. Sramko, J. Venlet, KC. Siontis, S. Kumar, R. Singh, I. Nakajima, SRD. Piers, M. de Riva Silva, CA. Glashan, T. Crawford, UB. Tedrow, WG. Stevenson, F. Bogun, K. Zeppenfeld

. 2020 ; 6 (6) : 696-707. [pub] 20200429

Language English Country United States

Document type Journal Article, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc21026694

OBJECTIVES: This study sought to investigate the value of electroanatomical voltage mapping (EAVM) to distinguish cardiac sarcoidosis (CS) from arrhythmogenic right ventricular cardiomyopathy (ARVC) in patients with ventricular tachycardia from the right ventricle (RV). BACKGROUND: CS can mimic ARVC. Because scar in ARVC is predominantly subepicardial, this study hypothesized that the relative sizes of endocardial low bipolar voltage (BV) to low unipolar voltage (UV) areas may distinguish CS from ARVC. METHODS: Patients with CS affecting the RV (n = 14), patients with gene-positive ARVC (n = 13), and a reference group of patients without structural heart disease (n = 9) who underwent RV endocardial EAVM were included. RV region-specific BV and UV cutoffs were derived from control subjects. In CS and ARVC, segmental involvement was determined and low-voltage areas were measured, using <1.5 mV for BV and <3.9 mV, <4.4 mV, and <5.5 mV for UV. The ratio between low BV and low UV area was calculated generating 3 parameters: Ratio3.9, Ratio4.4 and Ratio5.5, respectively. RESULTS: In control subjects, BV and UV varied significantly among RV regions. The basal septum was involved in 71% of CS patients and in none of ARVC patients. Ratio5.5 discriminated CS from ARVC the best. An algorithm including Ratio5.5 ≥0.45 and basal septal involvement identified CS with 93% sensitivity and 85% specificity. This was validated in a separate population (CS [n = 6], ARVC [n = 10]) with 100% sensitivity and 100% specificity. CONCLUSIONS: EAVM provides detailed information about scar characteristics and scar distribution in the RV. An algorithm combining Ratio5.5 (area BV <1.5 mV/area UV <5.5 mV) and bipolar basal septal involvement allows accurate diagnosis of (isolated) CS in patients presenting with monomorphic ventricular tachycardia from the RV.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc21026694
003      
CZ-PrNML
005      
20211026132706.0
007      
ta
008      
211013s2020 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1016/j.jacep.2020.02.008 $2 doi
035    __
$a (PubMed)32553221
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Hoogendoorn, Jarieke C $u Department of Cardiology, Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden University Medical Center, Leiden, the Netherlands
245    10
$a Electroanatomical Voltage Mapping to Distinguish Right-Sided Cardiac Sarcoidosis From Arrhythmogenic Right Ventricular Cardiomyopathy / $c JC. Hoogendoorn, M. Sramko, J. Venlet, KC. Siontis, S. Kumar, R. Singh, I. Nakajima, SRD. Piers, M. de Riva Silva, CA. Glashan, T. Crawford, UB. Tedrow, WG. Stevenson, F. Bogun, K. Zeppenfeld
520    9_
$a OBJECTIVES: This study sought to investigate the value of electroanatomical voltage mapping (EAVM) to distinguish cardiac sarcoidosis (CS) from arrhythmogenic right ventricular cardiomyopathy (ARVC) in patients with ventricular tachycardia from the right ventricle (RV). BACKGROUND: CS can mimic ARVC. Because scar in ARVC is predominantly subepicardial, this study hypothesized that the relative sizes of endocardial low bipolar voltage (BV) to low unipolar voltage (UV) areas may distinguish CS from ARVC. METHODS: Patients with CS affecting the RV (n = 14), patients with gene-positive ARVC (n = 13), and a reference group of patients without structural heart disease (n = 9) who underwent RV endocardial EAVM were included. RV region-specific BV and UV cutoffs were derived from control subjects. In CS and ARVC, segmental involvement was determined and low-voltage areas were measured, using <1.5 mV for BV and <3.9 mV, <4.4 mV, and <5.5 mV for UV. The ratio between low BV and low UV area was calculated generating 3 parameters: Ratio3.9, Ratio4.4 and Ratio5.5, respectively. RESULTS: In control subjects, BV and UV varied significantly among RV regions. The basal septum was involved in 71% of CS patients and in none of ARVC patients. Ratio5.5 discriminated CS from ARVC the best. An algorithm including Ratio5.5 ≥0.45 and basal septal involvement identified CS with 93% sensitivity and 85% specificity. This was validated in a separate population (CS [n = 6], ARVC [n = 10]) with 100% sensitivity and 100% specificity. CONCLUSIONS: EAVM provides detailed information about scar characteristics and scar distribution in the RV. An algorithm combining Ratio5.5 (area BV <1.5 mV/area UV <5.5 mV) and bipolar basal septal involvement allows accurate diagnosis of (isolated) CS in patients presenting with monomorphic ventricular tachycardia from the RV.
650    12
$a arytmogenní dysplazie pravé komory $x diagnóza $7 D019571
650    _2
$a elektrokardiografie $7 D004562
650    _2
$a elektrofyziologické techniky kardiologické $7 D022062
650    _2
$a lidé $7 D006801
650    12
$a sarkoidóza $x komplikace $x diagnóza $7 D012507
650    12
$a komorová tachykardie $x diagnóza $7 D017180
655    _2
$a časopisecké články $7 D016428
655    _2
$a práce podpořená grantem $7 D013485
700    1_
$a Sramko, Marek $u Department of Cardiology, Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
700    1_
$a Venlet, Jeroen $u Department of Cardiology, Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden University Medical Center, Leiden, the Netherlands
700    1_
$a Siontis, Konstantinos C $u Department of Cardiology, University of Michigan, Ann Arbor, Michigan, USA
700    1_
$a Kumar, Saurabh $u Department of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
700    1_
$a Singh, Robin $u Department of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
700    1_
$a Nakajima, Ikutaro $u Department of Cardiology, Vanderbilt Medical University Center, Nashville, Tennessee, USA
700    1_
$a Piers, Sebastiaan R D $u Department of Cardiology, Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden University Medical Center, Leiden, the Netherlands
700    1_
$a de Riva Silva, Marta $u Department of Cardiology, Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden University Medical Center, Leiden, the Netherlands
700    1_
$a Glashan, Claire A $u Department of Cardiology, Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden University Medical Center, Leiden, the Netherlands
700    1_
$a Crawford, Thomas $u Department of Cardiology, University of Michigan, Ann Arbor, Michigan, USA
700    1_
$a Tedrow, Usha B $u Department of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
700    1_
$a Stevenson, William G $u Department of Cardiology, Vanderbilt Medical University Center, Nashville, Tennessee, USA
700    1_
$a Bogun, Frank $u Department of Cardiology, University of Michigan, Ann Arbor, Michigan, USA
700    1_
$a Zeppenfeld, Katja $u Department of Cardiology, Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: k.zeppenfeld@lumc.nl
773    0_
$w MED00193518 $t JACC. Clinical electrophysiology $x 2405-5018 $g Roč. 6, č. 6 (2020), s. 696-707
856    41
$u https://pubmed.ncbi.nlm.nih.gov/32553221 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20211013 $b ABA008
991    __
$a 20211026132712 $b ABA008
999    __
$a ok $b bmc $g 1715434 $s 1147201
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2020 $b 6 $c 6 $d 696-707 $e 20200429 $i 2405-5018 $m JACC. Clinical electrophysiology $n JACC Clin Electrophysiol $x MED00193518
LZP    __
$a Pubmed-20211013
Back

Find record

Citation metrics

Archiving options