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- Title
Repolarization abnormalities unmasked with a 252‐lead BSM system in patients with ARVC and healthy gene carriers.
- Authors
Kommata, Varvara; Sciaraffia, Elena; Blomström‐Lundqvist, Carina
- Abstract
Background: Diagnosing arrhythmogenic right ventricular cardiomyopathy (ARVC) at an early stage can be challenging even after ECG recording and a combination of several imaging techniques. The purpose of this study was to explore if a body surface mapping (BSM) system with 252‐leads could identify repolarization abnormalities and thereby diagnose early stages of ARVC. Methods: ARVC patients, gene carriers without signs of ARVC and controls underwent a 12‐lead resting ECG, signal‐averaged ECG, echocardiography, 24‐hours Holter monitoring, and BSM with electrocardiographic imaging (ECGI). All 252‐leads, divided into four quadrants of the vest, were analyzed regarding concordances between T wave polarity and QRS main vector. Results: Of 40 patients included there were 12 ARVC patients, 20 gene carriers, and 8 controls. The ARVC patients had two different repolarization patterns, one with more pronounced negative T waves at the lower left panel and another with mixed changes that clearly differed from the controls, all of whom had a normal 12 lead ECGs and consistent repolarization patterns on their BSM recordings. The patterns observed in ARVC patients were also present in 5/20 (25%) gene carriers, three of whom had normal resting ECG. A novel repolarization index successfully detected all ARVC patients and 88% of gene carriers with pathologic repolarization pattern. Conclusions: The finding that abnormal repolarization patterns could be unmasked by BSM in 25% of healthy gene carriers, suggests that it may potentially be a useful tool for identifying early manifestations of ARVC. Further and larger studies are warranted to assess its diagnostic accuracy.
- Subjects
SWEDEN; ECHOCARDIOGRAPHY; AMBULATORY electrocardiography; GENETIC mutation; ARRHYTHMOGENIC right ventricular dysplasia; BODY surface mapping; ELECTROCARDIOGRAPHY; DESCRIPTIVE statistics; SENSITIVITY &; specificity (Statistics); EARLY diagnosis
- Publication
Pacing & Clinical Electrophysiology, 2022, Vol 45, Issue 4, p509
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.14456