Abstract
The hallmark lesion of arrhythmogenic right ventricular cardiomyopathy (ARVC/D) is the RV myocardial loss with replacement by fibrofatty tissue. Emerging tools offer the possibility to directly visualize fibrofatty ventricular scar. electroanatomic voltage mapping (EVM) by CARTO system has been demonstrated to identify low-voltage myocardial areas (“electroanatomic scar”, EAS) invasively, whereas contrast-enhanced cardiac magnetic resonance CE-CMR has the potential to detect regions of delayed contrast-enhancement (“DCE scar”) non-invasively.
Highlights
The hallmark lesion of arrhythmogenic right ventricular cardiomyopathy (ARVC/D) is the RV myocardial loss with replacement by fibrofatty tissue
RV electroanatomic voltage mapping (EVM) was abnormal in 21/23 (91%) patients, with a total of 45 EAS: 17 (38%) in the infero-basal region, 12 (26.6%) in the antero-lateral region, 8 (17.7%) in the RV outflow tract (RVOT) and 8 (17.7%) in the apex
Comparative analysis showed a mismatch in 24 RV scar areas, with 22 EAS not confirmed by the DCE (13 in the infero-basal region, 3 in antero-lateral region, 4 in RVOT and 2 on apex), and 2 DCE scars undetected by the EVM
Summary
The hallmark lesion of arrhythmogenic right ventricular cardiomyopathy (ARVC/D) is the RV myocardial loss with replacement by fibrofatty tissue. Emerging tools offer the possibility to directly visualize fibrofatty ventricular scar. Electroanatomic voltage mapping (EVM) by CARTO system has been demonstrated to identify lowvoltage myocardial areas (“electroanatomic scar”, EAS) invasively, whereas contrast-enhanced cardiac magnetic resonance CE-CMR has the potential to detect regions of delayed contrast-enhancement (“DCE scar”) noninvasively. Purpose The aim of the present study was to compare EVM and CE-CMR for imaging scar lesion in ARVC/D patients Emerging tools offer the possibility to directly visualize fibrofatty ventricular scar. electroanatomic voltage mapping (EVM) by CARTO system has been demonstrated to identify lowvoltage myocardial areas (“electroanatomic scar”, EAS) invasively, whereas contrast-enhanced cardiac magnetic resonance CE-CMR has the potential to detect regions of delayed contrast-enhancement (“DCE scar”) noninvasively.
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