Diagnostic Value of Endomyocardial Biopsy Guided by Electroanatomic Voltage Mapping in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia
- 5 November 2008
- journal article
- research article
- Published by Wiley in Journal of Cardiovascular Electrophysiology
- Vol. 19 (11), 1127-1134
- https://doi.org/10.1111/j.1540-8167.2008.01228.x
Abstract
Introduction: To improve the endomyocardial biopsy (EMB) diagnostic sensitivity for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D), we hypothesized a biopsy sampling focused on selected right ventricle (RV) low‐voltage areas identified by electroanatomic voltage mapping. Methods and Results: The study population (22 patients, 10 men; mean age 34 ± 10 years) included 11 patients with overt ARVC/D (group A) and 11 patients with suspected ARVC/D (group B), according to both arrhythmic profile and standardized noninvasive diagnostic criteria. In all 22 patients, an RV bipolar voltage mapping was performed with CARTO™ system sampling multiple endocardial sites (262 ± 61), during sinus rhythm, with a 0.5–1.5 mV color range setting of voltage display. All 11 (100%) group A patients and 8 of the 11 (73%) group B patients (P = nonsignificant [NS]) presented RV low‐voltage areas (Conclusions: The results of our study (1) confirm the high diagnostic sensitivity of RV voltage mapping in patients with overt ARVC/D, (2) document a high prevalence of RV low‐voltage areas even in patients with suspected ARVC/D, and (3) demonstrate that in patients with clinical evidence or suspicion for ARVC/D, presenting RV low‐voltage areas, EMB guided by voltage mapping may provide ARVC/D diagnosis confirmation.Keywords
This publication has 19 references indexed in Scilit:
- Using the 12‐Lead ECG to Localize the Origin of Atrial and Ventricular Tachycardias: Part 2—Ventricular TachycardiaJournal of Cardiovascular Electrophysiology, 2009
- The Role of Endomyocardial Biopsy in the Management of Cardiovascular DiseaseJournal of the American College of Cardiology, 2007
- Endomyocardial Biopsy Guided by Electroanatomic Voltage Mapping in Arrhythmogenic Right Ventricular Cardiomyopathy: A Case ReportJournal of Cardiovascular Electrophysiology, 2007
- Three-Dimensional Electroanatomic Voltage Mapping Increases Accuracy of Diagnosing Arrhythmogenic Right Ventricular Cardiomyopathy/DysplasiaCirculation, 2005
- Usefulness of electroanatomical mapping to differentiate between right ventricular outflow tract tachycardia and arrhythmogenic right ventricular dysplasiaThe American Journal of Cardiology, 2005
- Histologic findings in patients with clinical and instrumental diagnosis of sporadic arrhythmogenic right ventricular dysplasiaJournal of the American College of Cardiology, 2004
- Characterization of Endocardial Electrophysiological Substrate in Patients With Nonischemic Cardiomyopathy and Monomorphic Ventricular TachycardiaCirculation, 2003
- Endomyocardial biopsy in arrhythmogenic right ventricular cardiomyopathyAmerican Heart Journal, 1996
- Potential role for endomyocardial biopsy in the clinical characterization of patients with idiopathic ventricular fibrillation: Arrhythmogenic right ventricular dysplasia—an undervalued causeAmerican Heart Journal, 1994
- Echocardiographic measurement of the normal adult right ventricle.Heart, 1986