Arrhythmias & electrophysiology
Relationship between electrical and morphologic alterations of the right ventricle in arrhythmogenic right ventricular cardiomyopathy
Authors' conclusion
In ARVC, arrhythmogenic substrates frequently exist without overt morphologic changes. Electrophysiological studies provide additional diagnostic value, supporting its integration into diagnostic criteria.
Study context
- Population
- Patients with definite arrhythmogenic right ventricular cardiomyopathy (ARVC) who underwent computed tomography imaging and endocardial/epicardial ventricular tachycardia ablationpatients with definite ARVC (mean age 42 ± 14 years, 82% male)
- Participants
- 34 patients
- Exposure
- Spatial association between low-voltage areas (LVAs) and morphofunctional abnormalities (static or kinetic) across 7 right ventricular regions
- Outcome
- Epicardial LVAs by segment morphology
Main finding
As reported in the abstract
- Present in morphologically normal segments
- 95%-96%
- Correlation with morphology (kappa)
- κ ≈ 0.04-0.05
Observational data: associations, not effects.
Further findings
Endocardial LVAs by segment morphology
- Endocardial LVAs by segment morphology — correlation (kappa)
- κ < 0.25
- Endocardial LVAs by segment morphology: P < .02
Endocardial LVAs by segment morphology
- More than half of morphologically normal segments had endocardial scars
Transmural LVAs
- Found in abnormal segments but uncommon overall; spatial concordance poor
- κ < 0.10
Transmural fat and LVAs
- Transmural fat correlated with endocardial LVAs
- 12% vs 1%; P = .016
- Correlation with epicardial LVAs
- κ < 0.39
Ventricular tachycardia isthmus segments lacking any morphofunctional abnormality
- Isthmus segments without morphofunctional abnormality
- 33%
Original publication
Relationship between electrical and morphologic alterations of the right ventricle in arrhythmogenic right ventricular cardiomyopathy. Heart Rhythm. Published 11 September 2025. doi:10.
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