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Delasnerie H, Gandjbakhch E, Sauve R, Beneyto M, Domain G, Voglimacci-Stephanopoli Q, Mandel F, Badenco N, Waintraub X, Mondoly P, Fressart V, Rollin A, Maury P. Correlations Between Endocardial Voltage Mapping, Diagnosis, and Genetics in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy. Am J Cardiol 2023; 190:113-120. [PMID: 36621286 DOI: 10.1016/j.amjcard.2022.11.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/01/2022] [Accepted: 11/19/2022] [Indexed: 01/09/2023]
Abstract
The relations between endocardial voltage mapping and the genetic background of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) have not been investigated so far. A total of 97 patients with proved or suspected ARVC who underwent 3-dimensional endocardial mapping and genetic testing have been retrospectively included. Presence, localization, and size of scar areas were correlated to ARVC diagnosis and the presence of a pathogenic variant. A total of 78 patients (80%) presented with some bipolar or unipolar scar on endocardial voltage mapping, whereas 43 carried pathogenic variants (44%). Significant associations were observed between presence of endocardial scars on voltage mapping and previous or inducible ventricular tachycardia, right ventricular function and dimensions, or electrocardiogram features of ARVC. A total of 60 of the 78 patients (77%) with an endocardial scar fulfilled the criteria for a definitive arrhythmogenic right ventricular dysplasia diagnosis versus 8 of 19 patients (42%) without scar (p = 0.003). Patients with a definitive diagnosis of ARVC had more scars from any location and the scars were larger in patients with ARVC. In the 68 patients with a definitive diagnosis of ARVC, the presence of any endocardial scar was similar whether an ARVC-causal mutation was present or not. Only scar extent was significantly greater in patients with pathogenic variants. There was no difference in the presence and characteristics of scars in PKP2 mutated versus other mutated patients. The 3-dimensional endocardial mapping could have an important role for refining ARVC diagnosis and may be able to detect minor forms with otherwise insufficient criteria for diagnosis. The trend for larger scar extent were observed in mutated patients, without any difference according to the mutated genes.
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Affiliation(s)
- Hubert Delasnerie
- Department of Cardiology, Cardiology University Hospital Toulouse, Toulouse, France
| | - Estelle Gandjbakhch
- Department of Cardiology, Sorbonne Universités, AP-HP, Heart Institute, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Romain Sauve
- Biosense, Johnson & Johnson, Issy-les-Moulineaux, France
| | - Maxime Beneyto
- Department of Cardiology, Cardiology University Hospital Toulouse, Toulouse, France
| | - Guillaume Domain
- Department of Cardiology, Cardiology University Hospital Toulouse, Toulouse, France
| | | | - Franck Mandel
- Department of Cardiology, Cardiology University Hospital Toulouse, Toulouse, France
| | - Nicolas Badenco
- Department of Cardiology, Sorbonne Universités, AP-HP, Heart Institute, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Xavier Waintraub
- Department of Cardiology, Sorbonne Universités, AP-HP, Heart Institute, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Pierre Mondoly
- Department of Cardiology, Cardiology University Hospital Toulouse, Toulouse, France
| | - Véronique Fressart
- Service de Biochimie Métabolique, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Anne Rollin
- Department of Cardiology, Cardiology University Hospital Toulouse, Toulouse, France
| | - Philippe Maury
- Department of Cardiology, Cardiology University Hospital Toulouse, Toulouse, France; I2MC, Inserm UMR 1297, Toulouse, France.
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Hoogendoorn JC, Sramko M, Venlet J, Siontis KC, Kumar S, Singh R, Nakajima I, Piers SR, de Riva Silva M, Glashan CA, Crawford T, Tedrow UB, Stevenson WG, Bogun F, Zeppenfeld K. Electroanatomical Voltage Mapping to Distinguish Right-Sided Cardiac Sarcoidosis From Arrhythmogenic Right Ventricular Cardiomyopathy. JACC Clin Electrophysiol 2020; 6:696-707. [DOI: 10.1016/j.jacep.2020.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/13/2020] [Accepted: 02/20/2020] [Indexed: 12/21/2022]
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