Heart failure & cardiomyopathiesCohort study

Scar architecture affects the electrophysiological characteristics of induced ventricular arrhythmias in hypertrophic cardiomyopathy

EuropacePublished

  • Prospective cohort study
  • consecutive patients

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

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:10.1093/europace/euae050

Summarised from the published abstract; every number is checked against it