Arrhythmias & electrophysiology
Relationship of Structural Abnormalities of Papillary Muscles to the Site of Origin of Ventricular Arrhythmias
Authors' conclusion
Multimodality imaging identifies arrhythmogenic PAPs preprocedurally and in real time during the ablation procedure in most patients. Increased echogenicity, LGE, and calcifications are often seen on PAPs in patients with focal PAP arrhythmias and can indicate the site of origin.
Study context
- Population
- Patients with focal papillary muscle arrhythmias referred for ablationconsecutive
- Participants
- 43 patients
- Outcome
- Prevalence and location of structural abnormalities on papillary muscles (CMR, CT angiography, ICE) and their correlation with VA sites of origin
Methodological detailsobservational imaging study, consecutive patients, multimodality imaging
- Observational imaging study
- Consecutive patients
- Multimodality imaging
Main finding
As reported in the abstract
- Late gadolinium enhancement (LGE) on papillary muscles on CMR
- 19 of 43 patients
- Calcifications on CT
- 2 of 43
- Calcifications on intracardiac echocardiography (ICE)
- 3 of 43 patients
- Increased echogenicity on ICE
- 39 of 43 patients
- Focal papillary muscle arrhythmias identified
- 141
- VA target sites adjacent to increased echogenicity on ICE
- 59 of 141 (44%)
- VA target sites adjacent to LGE
- 35 of 141 (25%)
- VA target sites adjacent to calcifications
- 14 of 141 (10%)
- ≥1 VA target site localized to structural abnormalities
- 32 of 43 (74%) patients
Observational data: associations, not effects.
Original publication
Relationship of Structural Abnormalities of Papillary Muscles to the Site of Origin of Ventricular Arrhythmias. JACC Clin Electrophysiol. Published 18 December 2024. doi:10.
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