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Article Dans Une Revue EP-Europace Année : 2023

Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia

Mikael Laredo
Oholi Tovia-Brodie
  • Fonction : Auteur
Petr Peichl
  • Fonction : Auteur
Carla Giustetto
  • Fonction : Auteur
Andrea Radinovic
  • Fonction : Auteur
Paloma Jorda
  • Fonction : Auteur
Ruben Casado-Arroyo
  • Fonction : Auteur
Esther Zorio
  • Fonction : Auteur
Francisco Bermúdez-Jiménez
  • Fonction : Auteur
Elijah Behr
  • Fonction : Auteur
Stepan Havranek
  • Fonction : Auteur
Jacob Tfelt-Hansen
  • Fonction : Auteur
Frederic Sacher
  • Fonction : Auteur
Eyal Nof
  • Fonction : Auteur
Michela Casella
  • Fonction : Auteur
Josef Kautzner
  • Fonction : Auteur
Dominique Lacroix
  • Fonction : Auteur
Josep Brugada
  • Fonction : Auteur
Firat Duru
  • Fonction : Auteur
Paolo Della Bella
  • Fonction : Auteur
Richard Hauer
  • Fonction : Auteur
Bernard Belhassen
  • Fonction : Auteur

Résumé

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) 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.

Dates et versions

hal-04073543 , version 1 (18-04-2023)

Identifiants

Citer

Mikael Laredo, Oholi Tovia-Brodie, Anat Milman, Yoav Michowitz, Rob Roudijk, et al.. Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia. EP-Europace, 2023, 25 (3), pp.1025-1034. ⟨10.1093/europace/euac267⟩. ⟨hal-04073543⟩
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