| Fundamental differences in electrophysiologic and electroanatomic substrate between ischemic cardiomyopathy patients with and without clinical ventricular tachycardia. | |
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MedLine Citation:
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PMID: 19573735 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of this study was to compare the electrophysiologic substrate in ischemic cardiomyopathy (ICM) patients with and without sustained monomorphic ventricular tachycardia (SMVT). BACKGROUND: Despite the universal presence of potentially arrhythmogenic left ventricular (LV) scarring, it is not clear why the majority of ICM patients never develop SMVT. METHODS: Detailed electroanatomic mapping of the LV endocardium was performed in 17 stable control ICM patients (16 males) without clinical SMVT. They were compared with 17 ICM patients (15 males) with spontaneous SMVT. Standard definitions of low-voltage zones and fractionated, isolated, and very late potentials were used. RESULTS: There were no significant baseline differences between the groups in terms of LV diameter, ejection fraction (27% vs. 28%), infarct territory, or time from infarction. However, control patients had smaller total low-voltage area < or =1.5 mv (30% of surface area vs. 55%, p < 0.001); smaller very low-voltage area <0.5 mv (7.3% vs. 29%, p < 0.001); higher mean voltage of low-voltage zones; fewer fractionated, isolated, and very late potentials with lower density of these scar-related electrograms per unit low-voltage area; and less SMVT inducibility. Potential conducting channels within dense scar and adjacent to the mitral annulus were more frequent in SMVT patients. CONCLUSIONS: Compared with ICM patients with SMVT, an otherwise similar control group demonstrated markedly smaller endocardial low-voltage zones, lower scar-related electrogram density, and fewer conducting channels with faster conduction velocity. These findings may explain why some ICM patients develop SMVT and others do not. |
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Authors:
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Haris M Haqqani; Jonathan M Kalman; Kurt C Roberts-Thomson; Richard N Balasubramaniam; Raphael Rosso; Richard L Snowdon; Paul B Sparks; Jitendra K Vohra; Joseph B Morton |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 54 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-03 Completed Date: 2009-07-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 166-73 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Royal Melbourne Hospital, Grattan Street, Parkville, Victoria, Australia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Body Surface Potential Mapping / methods* Cardiomyopathies / complications, diagnosis, physiopathology* Diagnosis, Differential Electric Countershock / methods Electrophysiologic Techniques, Cardiac / methods* Female Follow-Up Studies Humans Male Middle Aged Myocardial Ischemia / complications, diagnosis, physiopathology* Prognosis Prospective Studies Stroke Volume / physiology Tachycardia, Ventricular / complications, physiopathology*, therapy Ventricular Dysfunction, Left / diagnosis, etiology, physiopathology |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2009 Jul 7;54(2):174-5
[PMID:
19573736
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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