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Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia
M. Laredo, O. Tovia-Brodie, A. Milman, Y. Michowitz, RW. Roudijk, G. Peretto, N. Badenco, ASJM. Te Riele, S. Sala, G. Duthoit, E. Arbelo, S. Ninni, A. Gasperetti, JP. van Tintelen, G. Paglino, X. Waintraub, A. Andorin, P. Peichl, LP. Bosman, L....
Language English Country England, Great Britain
Document type Journal Article
NLK
Free Medical Journals
from 1999 to 1 year ago
PubMed Central
from 2008
Open Access Digital Library
from 1999-01-01
Medline Complete (EBSCOhost)
from 1999-01-01
Oxford Journals Open Access Collection
from 1999-01-01
- MeSH
- Bundle-Branch Block MeSH
- Electrocardiography MeSH
- Cardiomyopathies * complications diagnosis MeSH
- Tachycardia, Ventricular * etiology complications MeSH
- Humans MeSH
- Heart Ventricles MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
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) data. METHODS AND RESULTS: From the European Survey on ACM, 70 patients with spontaneous RBBB-VT were included. Putative left ventricular (LV) 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%). T-wave inversion (TWI) was equally 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.
Cardiology Department Hospital Universitario Virgen de las Nieves Granada Spain
Center for Biomedical Network Research on Cardiovascular Diseases Madrid Spain
Centre Hospitalier Universitaire d'Amiens Picardie Amiens France
Department of Cardiology Erasme University Hospital Université Libre de Bruxelles Brussels Belgium
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiology University Heart Center Zurich Zurich Switzerland
Department of Cardiology University Medical Center Utrecht The Netherlands
Department of Genetics University Medical Center Utrecht The Netherlands
Division of Cardiology Policlinico Casilino Roma Italy
Hôpital Cardiologique du Haut Lévêque and Université Bordeaux LIRYC Institute Bordeaux France
IRCCS San Raffaele Scientific Institute Milan Italy
Netherlands Heart Institute Utrecht The Netherlands
Service de Cardiologie CHU de Nantes Nantes France
Université de Lille et Institut Cœur Poumon CHRU Lille Lille France
References provided by Crossref.org
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- $a Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia / $c M. Laredo, O. Tovia-Brodie, A. Milman, Y. Michowitz, RW. Roudijk, G. Peretto, N. Badenco, ASJM. Te Riele, S. Sala, G. Duthoit, E. Arbelo, S. Ninni, A. Gasperetti, JP. van Tintelen, G. Paglino, X. Waintraub, A. Andorin, P. Peichl, LP. Bosman, L. Calo, C. Giustetto, A. Radinovic, P. Jorda, R. Casado-Arroyo, E. Zorio, FJ. Bermúdez-Jiménez, ER. Behr, S. Havranek, J. Tfelt-Hansen, F. Sacher, JS. Hermida, E. Nof, M. Casella, J. Kautzner, D. Lacroix, J. Brugada, F. Duru, PD. Bella, E. Gandjbakhch, R. Hauer, B. Belhassen
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- $a 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) data. METHODS AND RESULTS: From the European Survey on ACM, 70 patients with spontaneous RBBB-VT were included. Putative left ventricular (LV) 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%). T-wave inversion (TWI) was equally 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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