Heart failure & cardiomyopathies
Scar architecture affects the electrophysiological characteristics of induced ventricular arrhythmias in hypertrophic cardiomyopathy
Authors' conclusion
Scar architecture determines inducibility and electrophysiological traits of VA in HCM.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM) undergoing late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) and programmed ventricular stimulation
- Participants
- 30 consecutive patients
- Exposure
- Scar architecture on LGE-CMR by inducibility of VA on programmed ventricular stimulation
- Non-induciblen = 13reference
- Inducible non-sustainedn = 6
- Inducible sustainedn = 11
- Outcome
- Association of scar composition (core, BZ fibrosis, BZ channels) with inducibility and electrophysiological traits of VA
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
BZ channels
- Scar mass (borderzone (BZ) and core) significantly increased from non-inducible to inducible non-sustained and sustained VA
- P = 0.002
- BZ channels across groups
- P = 0.003
Observational data: associations, not effects.
Further findings
LGE prevalence
- Patients with LGE
- 27 (90%)
- Patients with LGE and inducible VA
- 17 (57%)
- Patients induced with MMVT or monomorphic-initiated PVT/VF with LGE
- 13
Induced VA morphology
- MMVT among 17 induced VA
- 13 (76%)
- VT origin matching scar location
- 10/13
- Matching LGE regions with BZ channels
- 8/10
ICD shock for VF during follow-up · 20 months, interquartile range: 7-37
- Patient with BZ channels and inducible PVT with ICD shock for VF
- 1
Original publication
Scar architecture affects the electrophysiological characteristics of induced ventricular arrhythmias in hypertrophic cardiomyopathy. Europace. Published 20 February 2024. doi:10.
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