Cardiology Medical News about cardiomyopathy;clinical ventricular tachycardia

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Fundamental differences in electrophysiologic and electroanatomic substrate between ischemic cardiomyopathy patients with and without clinical ventricular tachycardia
JACC - Journal of the American College of Cardiology, 07/02/09

Haqqani HM et al. – Compared with ischemic cardiomyopathy (ICM) pts with sustained monomorphic ventricular tachycardia (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 pts develop SMVT.

Methods

Study to compare electrophysiologic substrate in ICM pts with/without SMVT

Results

Detailed electroanatomic mapping of left ventricular (LV) endocardium in 17 stable control ICM pts (16 males) without clinical SMVT
Comparison with 17 ICM pts (15 males) with spontaneous SMVT
Standard definitions of low-voltage zones and fractionated, isolated, and very late potentials
No significant baseline differences between groups in terms of LV diameter, ejection fraction (27% vs 28%), infarct territory, or time from infarction
Control pts had smaller total low-voltage area ≤1.5 mv (30% of surface area vs 55%); smaller very low-voltage area <0.5 mv (7.3% vs. 29%); 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 more frequent in SMVT pts

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