TY - GEN
T1 - Disease-Specific Electrocardiographic Lead Positioning for Early Detection of Arrhythmogenic Right Ventricular Cardiomyopathy
AU - Ruisch, Janna
AU - Boonstra, Machteld J.
AU - Roudijk, Rob W.
AU - van Dam, Peter M.
AU - Slump, Cornelis H.
AU - Loh, Peter
N1 - Funding Information:
This work was supported by the Netherlands Cardiovascular Research Initiative, an initiative with support of the Dutch Heart Foundation (grant numbers CVON2015-12 eDETECT and QRS-Vision 2018B007).
Publisher Copyright:
© 2020 Creative Commons; the authors hold their copyright.
PY - 2020/9/13
Y1 - 2020/9/13
N2 - Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by replacement of cardiomyocytes by fibrofatty tissue which can lead to ventricular arrhythmias, heart failure or sudden cardiac death. Genetic defects in desmosomal proteins, as plakophilin-2 (PKP2), are known to contribute to disease development. Current electrocardiographic (ECG) criteria for ARVC diagnosis only focus on right precordial leads, but sensitivity of current depolarization criteria is limited. This study aimed to identify additional depolarization criteria with most optimal lead configurations for early detection of ARVC in PKP2 pathogenic mutation carriers. In PKP2-positive ARVC patients (n=7), PKP2 pathogenic variant carriers (n=16) and control subjects without structural heart disease (n=9), 67-lead body surface potential maps (BSPM) were obtained. Terminal QRS-integrals were determined and quantitatively compared to controls using departure mapping. Significantly different terminal QRS-integrals were identified in lead 34 (conventional V3), 40 and 41 (conventional V4). To conclude, a clear distinction between ARVC patients, asymptomatic mutation carriers and healthy controls was observed.
AB - Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by replacement of cardiomyocytes by fibrofatty tissue which can lead to ventricular arrhythmias, heart failure or sudden cardiac death. Genetic defects in desmosomal proteins, as plakophilin-2 (PKP2), are known to contribute to disease development. Current electrocardiographic (ECG) criteria for ARVC diagnosis only focus on right precordial leads, but sensitivity of current depolarization criteria is limited. This study aimed to identify additional depolarization criteria with most optimal lead configurations for early detection of ARVC in PKP2 pathogenic mutation carriers. In PKP2-positive ARVC patients (n=7), PKP2 pathogenic variant carriers (n=16) and control subjects without structural heart disease (n=9), 67-lead body surface potential maps (BSPM) were obtained. Terminal QRS-integrals were determined and quantitatively compared to controls using departure mapping. Significantly different terminal QRS-integrals were identified in lead 34 (conventional V3), 40 and 41 (conventional V4). To conclude, a clear distinction between ARVC patients, asymptomatic mutation carriers and healthy controls was observed.
UR - http://www.scopus.com/inward/record.url?scp=85100947760&partnerID=8YFLogxK
U2 - 10.22489/CinC.2020.334
DO - 10.22489/CinC.2020.334
M3 - Conference contribution
AN - SCOPUS:85100947760
T3 - Computing in Cardiology (CinC)
BT - 2020 Computing in Cardiology, CinC 2020
PB - IEEE Computer Society Press
CY - Piscataway, NJ
T2 - 2020 Computing in Cardiology, CinC 2020
Y2 - 13 September 2020 through 16 September 2020
ER -