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Myocardial voltage ratio in arrhythmogenic right ventricular dysplasia/cardiomyopathy
Andreas Müssigbrodt1, Livio Bertagnolli2, Elena Efimova2
1Department of Electrophysiology, Heart Centre, University of Leipzig, Strümpellstrasse 39, 04289, Leipzig, Germany. andreas.muessigbrodt@gmail.com.
Aims:
This study aimed to analyze the influence of scar distribution between the endocardium and the epicardium in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C).
Methods:
Electroanatomical mapping data were derived from our ARVD/C registry. Myocardial voltage distribution between the endocardium and the epicardium was analyzed in 28 patients (18 men, 49.9 ± 13.0 years) with previous ventricular tachycardia (VT) ablation and complete right ventricular maps.
Results:
During the follow-up period of 28 ± 22 months after ablation, 18 of 28 patients (64.3%) remained free from VT recurrence. In univariate analysis, five variables associated with VT recurrence, i. e., advanced age, right ventricular (RV) myocardial voltage ratio ≥0.58, inducibility of VT after ablation, and longer procedure and fluoroscopy time. In binary logistic regression analysis only RV myocardial voltage ratio ≥0.58 (hazard ratio 11.667, 95% confidence interval 1.487-91.543, p = 0.012) remained associated with an increased risk of VT recurrence.
Conclusion:
The myocardial voltage ratio (bipolar low voltage area/unipolar low voltage area) as a potential surrogate parameter for scar distribution between the endocardium and the epicardium is significantly associated with the outcome after VT ablation in ARVD/C.
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