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Right Ventricular Endocardial Mapping and a Potential Arrhythmogenic Substrate in Cardiac Amyloidosis-Role of ICD

Aleksandra Liżewska-Springer1, Tomasz Królak1, Karolina Dorniak2

  • 1Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-952 Gdansk, Poland.

International Journal of Environmental Research and Public Health
|November 13, 2021
PubMed

Insights

Cardiac amyloidosis (CA) patients face high sudden cardiac death (SCD) risk. Electrophysiology studies aid SCD risk stratification before implantable cardioverter-defibrillator (ICD) placement in these controversial cases.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Amyloidosis Research

Background:

  • Patients with cardiac amyloidosis (CA) exhibit a heightened risk of sudden cardiac death (SCD).
  • The efficacy of implantable cardioverter-defibrillators (ICDs) for primary prevention of SCD in CA patients remains debated.
  • Recurrent syncope and non-sustained ventricular tachycardia are clinical indicators requiring further risk assessment.

Observation:

  • A case study involving a patient with cardiac amyloidosis presenting with recurrent syncope and non-sustained ventricular tachycardia.
  • An electrophysiological study was conducted to assess SCD risk.
  • Endocardial electroanatomic voltage mapping was utilized as part of the risk stratification process.

Findings:

  • Electrophysiological study and voltage mapping provide detailed insights into ventricular arrhythmogenesis in CA.
  • These advanced diagnostic tools can help refine patient selection for ICD therapy.
  • The findings contribute to the ongoing discussion regarding primary prevention strategies for SCD in CA.

Implications:

  • This case highlights the utility of electrophysiological assessment in managing CA patients at high risk for SCD.
  • Improved risk stratification may lead to more personalized and effective therapeutic decisions.
  • Further research is warranted to establish definitive guidelines for ICD use in cardiac amyloidosis.

Keywords:
cardiac amyloidosiselectrophysiological study mappingimplantable cardioverter-defibrillatorsudden cardiac death

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