Localized Structural Alterations Underlying a Subset of Unexplained Sudden Cardiac Death

Circulation. Arrhythmia and Electrophysiology
M HaïssaguerreRemi Dubois

Abstract

Sudden cardiac death because of ventricular fibrillation (VF) is commonly unexplained in younger victims. Detailed electrophysiological mapping in such patients has not been reported. We evaluated 24 patients (29±13 years) who survived idiopathic VF. First, we used multielectrode body surface recordings to identify the drivers maintaining VF. Then, we analyzed electrograms in the driver regions using endocardial and epicardial catheter mapping during sinus rhythm. Established electrogram criteria were used to identify the presence of structural alterations. VF occurred spontaneously in 3 patients and was induced in 16, whereas VF was noninducible in 5. VF mapping demonstrated reentrant and focal activities (87% versus 13%, respectively) in all. The activities were dominant in one ventricle in 9 patients, whereas they had biventricular distribution in others. During sinus rhythm areas of abnormal electrograms were identified in 15/24 patients (62.5%) revealing localized structural alterations: in the right ventricle in 11, the left ventricle in 1, and both in 3. They covered a limited surface (13±6 cm2) representing 5±3% of the total surface and were recorded predominantly on the epicardium. Seventy-six percent of these areas we...Continue Reading

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Citations

May 11, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Edmond M CroninUNKNOWN ESC Scientific Document Group
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Sep 11, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Giulio ConteAngelo Auricchio
Feb 18, 2020·Circulation. Arrhythmia and Electrophysiology·Balvinder S HandaFu Siong Ng
Oct 4, 2018·Frontiers in Cardiovascular Medicine·Ghassen ChenitiMichel Haissaguerre
Oct 11, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Giulio ConteMichael J Ackerman
Sep 12, 2020·Circulation. Arrhythmia and Electrophysiology·Philippe MauryRémi Dubois
Feb 9, 2021·Circulation. Arrhythmia and Electrophysiology·David E KrummenSanjiv M Narayan
Feb 17, 2021·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Mariam MeddebTimm Dickfeld
Aug 12, 2019·Cardiac Electrophysiology Clinics·Ghassen ChenitiMichel Haissaguerre
Aug 27, 2021·Journal of Cardiovascular Development and Disease·Caroline ChoquetLucile Miquerol
Nov 6, 2018·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Michel HaïssaguerreOlivier Bernus

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Methods Mentioned

BETA
imaging techniques

Software Mentioned

SPSS

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