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

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

doi:10.1093/europace/euac267

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

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

^*Corresponding author for this work

Cardiology

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

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 From the European Survey on ACM, 70 patients with spontaneous RBBB-VT were included. Putative left ventricular (LV) and ^results 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%).

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.

Original language	English
Pages (from-to)	1025-1034
Number of pages	10
Journal	Europace
Volume	25
Issue number	3
DOIs	https://doi.org/10.1093/europace/euac267
State	Published - 1 Mar 2023

Keywords

Arrhythmogenic cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy
ECG Site of origin
Ventricular arrhythmia

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10.1093/europace/euac267

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Laredo, M., Tovia-Brodie, O., Milman, A., Michowitz, Y., Roudijk, R. W., Peretto, G., Badenco, N., te Riele, A. S. J. M., Sala, S., Duthoit, G., Arbelo, E., Ninni, S., Gasperetti, A., Tintelen, J. P. V., Paglino, G., Waintraub, X., Andorin, A., Peichl, P., Bosman, L. P., ... Belhassen, B. (2023). Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia. Europace, 25(3), 1025-1034. https://doi.org/10.1093/europace/euac267

@article{4a207d8afc2142628b03bcef73b427df,

title = "Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia",

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 From the European Survey on ACM, 70 patients with spontaneous RBBB-VT were included. Putative left ventricular (LV) and results 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%).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.",

keywords = "Arrhythmogenic cardiomyopathy, Arrhythmogenic right ventricular cardiomyopathy, ECG Site of origin, Ventricular arrhythmia",

author = "Mikael Laredo and Oholi Tovia-Brodie and Anat Milman and Yoav Michowitz and Roudijk, {Rob W.} and Giovanni Peretto and Nicolas Badenco and {te Riele}, {Anneline S.J.M.} and Simone Sala and Guillaume Duthoit and Elena Arbelo and Sandro Ninni and Alessio Gasperetti and Tintelen, {J. Peter van} and Gabriele Paglino and Xavier Waintraub and Antoine Andorin and Petr Peichl and Bosman, {Laurens P.} and Leonardo Calo and Carla Giustetto and Andrea Radinovic and Paloma Jorda and Ruben Casado-Arroyo and Esther Zorio and Berm{\'u}dez-Jim{\'e}nez, {Francisco J.} and Behr, {Elijah R.} and Stepan Havranek and Jacob Tfelt-Hansen and Frederic Sacher and Hermida, {Jean Sylvain} and Eyal Nof and Michela Casella and Josef Kautzner and Dominique Lacroix and Josep Brugada and Firat Duru and Bella, {Paolo Della} and Estelle Gandjbakhch and Richard Hauer and Bernard Belhassen",

year = "2023",

month = mar,

day = "1",

doi = "10.1093/europace/euac267",

language = "אנגלית",

volume = "25",

pages = "1025--1034",

journal = "Europace",

issn = "1099-5129",

publisher = "Oxford University Press",

number = "3",

}

Laredo, M, Tovia-Brodie, O, Milman, A , Michowitz, Y, Roudijk, RW, Peretto, G, Badenco, N, te Riele, ASJM, Sala, S, Duthoit, G, Arbelo, E, Ninni, S, Gasperetti, A, Tintelen, JPV, Paglino, G, Waintraub, X, Andorin, A, Peichl, P, Bosman, LP, Calo, L, Giustetto, C, Radinovic, A, Jorda, P, Casado-Arroyo, R, Zorio, E, Bermúdez-Jiménez, FJ, Behr, ER, Havranek, S, Tfelt-Hansen, J, Sacher, F, Hermida, JS, Nof, E, Casella, M, Kautzner, J, Lacroix, D, Brugada, J, Duru, F, Bella, PD, Gandjbakhch, E, Hauer, R & Belhassen, B 2023, 'Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia', Europace, vol. 25, no. 3, pp. 1025-1034. https://doi.org/10.1093/europace/euac267

TY - JOUR

T1 - Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia

AU - Laredo, Mikael

AU - Tovia-Brodie, Oholi

AU - Milman, Anat

AU - Michowitz, Yoav

AU - Roudijk, Rob W.

AU - Peretto, Giovanni

AU - Badenco, Nicolas

AU - te Riele, Anneline S.J.M.

AU - Sala, Simone

AU - Duthoit, Guillaume

AU - Arbelo, Elena

AU - Ninni, Sandro

AU - Gasperetti, Alessio

AU - Tintelen, J. Peter van

AU - Paglino, Gabriele

AU - Waintraub, Xavier

AU - Andorin, Antoine

AU - Peichl, Petr

AU - Bosman, Laurens P.

AU - Calo, Leonardo

AU - Giustetto, Carla

AU - Radinovic, Andrea

AU - Jorda, Paloma

AU - Casado-Arroyo, Ruben

AU - Zorio, Esther

AU - Bermúdez-Jiménez, Francisco J.

AU - Behr, Elijah R.

AU - Havranek, Stepan

AU - Tfelt-Hansen, Jacob

AU - Sacher, Frederic

AU - Hermida, Jean Sylvain

AU - Nof, Eyal

AU - Casella, Michela

AU - Kautzner, Josef

AU - Lacroix, Dominique

AU - Brugada, Josep

AU - Duru, Firat

AU - Bella, Paolo Della

AU - Gandjbakhch, Estelle

AU - Hauer, Richard

AU - Belhassen, Bernard

PY - 2023/3/1

Y1 - 2023/3/1

N2 - 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 From the European Survey on ACM, 70 patients with spontaneous RBBB-VT were included. Putative left ventricular (LV) and results 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%).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.

AB - 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 From the European Survey on ACM, 70 patients with spontaneous RBBB-VT were included. Putative left ventricular (LV) and results 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%).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.

KW - Arrhythmogenic cardiomyopathy

KW - Arrhythmogenic right ventricular cardiomyopathy

KW - ECG Site of origin

KW - Ventricular arrhythmia

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DO - 10.1093/europace/euac267

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C2 - 36635857

AN - SCOPUS:85151573534

SN - 1099-5129

VL - 25

SP - 1025

EP - 1034

JO - Europace

JF - Europace

IS - 3

ER -

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

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