Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia.
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Laredo Mikael, Tovia-Brodie Oholi, Milman Anat, Michowitz Yoav, Roudijk Rob W, Peretto Giovanni, Badenco Nicolas, Te Riele Anneline S J M, Sala Simone, Duthoit Guillaume, Arbelo Elena, Ninni Sandro, Gasperetti Alessio, van Tintelen J Peter, Paglino Gabriele, Waintraub Xavier, Andorin Antoine, Peichl Petr, Bosman Laurens P, Calo Leonardo, Giustetto Carla, Radinovic Andrea, Jorda Paloma, Casado-Arroyo Ruben, Zorio Esther, Bermúdez-Jiménez Francisco J, Behr Elijah R, Havranek Stepan, Tfelt-Hansen Jacob, Sacher Frederic, Hermida Jean-Sylvain, Nof Eyal, Casella Michela, Kautzner Josef, Lacroix Dominique, Brugada Josep, Duru Firat, Bella Paolo Della, Gandjbakhch Estelle, Hauer Richard, Belhassen Bernard
Аннотация
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.