A novel workflow for advanced mapping of repolarization dispersion from endocardial unipolar electrograms in patients with coved-type brugada syndrome Article Swipe
S Latrofa
,
S Garibaldi
,
Shaiana Vilella Hartwig
,
Luca Panchetti
,
M S Morelli
,
N Martini
,
N Zaurino
,
G Mansi
,
Gianluca Mirizzi
,
Umberto Startari
,
Claudio Passino
,
Michele Emdin
,
Marcello Piacenti
,
Alberto Giannoni
,
Andrea Rossi
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/europace/euad122.257
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/europace/euad122.257
Funding Acknowledgements Type of funding sources: None. Background Accentuation of the action potential notch in the epicardium causes the prolongation of the epicardial action potentials in the right ventricular outflow tract (RVOT) and is the basis for arrhythmogenesis in patients affected by Brugada syndrome (BrS). Activation-recovery interval (ARI) approximates the action potential duration and may be used to study repolarization dispersion in BrS. Purpose Our aim was to investigate repolarization dispersion within the RVOT in spontaneous coved-type ECG BrS patients and in controls, evaluating also the relation between repolarization dispersion and conduction abnormalities to better define the electro-anatomical substrate of the disease. Methods BrS probands (n=13) and control subjects (n=4) underwent endocardial mapping of RV with the CARTO 3 system. BrS patients were also studied with programmed ventricular stimulation (PVS). Data was exported from the CARTO system and converted into MatLab format using OpenEP. A specific region of interest (ROI) including the sub-pulmonary RVOT and entire RV free wall was then selected using Paraview. With an automated algorithm, we measured ARI and ARIc (corrected using the "Bazett formula") for each point of the ROI, which were then interpolated to obtain ARI maps. We also acquired right ventricular activation time (RVAT) and maps for the assessment of slow conduction zones. By dividing RVAT color scale in 5 ms steps (isoSteps), isochronal activation areas were identified in the ROI. Results Out of the 13 BrS subjects, 4 had VT or VF inducible during PVS (PVS+) while 9 did not (PVS-). One patient had appropriate ICD shocks during follow-up. BrS patients had higher mean ARI and ARIc compared to controls (288.5±22.2 vs 251.5±8.4 ms, p<0.001; 312.0±30.4 vs 281.8±10.3 ms, p=0.023). ARI was found to be higher in PVS+ than in PVS- patients (294.8±27.1 vs 285.8±20.1 ms, p=0.5), as well as ARIc (327.7±49.9 vs 304.6±16.4 ms, p=0.49) although these differences were not significant. BrS patients showed a longer RVAT (106.0±21.4 vs 74.5±5.5 ms, p=0.003), and increased zones of crowding, as expressed by isochronal steps (13.85±2.94 vs 9.25±1.26, p=0.01). Notably, a strong correlation was found between ARIc and RVAT (Pearson R coefficient = 0.83, p<0.05), independently from the results of PVS (PVS+ R=0.99, p=0.01; PVS- R=0.83, p=0.06). Conclusions We introduced a novel workflow for the electrical substrate characterisation of subjects with BrS phenotype. Our preliminary data show the presence of repolarization dispersion along with conduction slowing in the RVOT of BrS patients compared to controls. In our population, repolarization dispersion and impairment of RVOT conduction were strongly related especially in inducible BrS patients.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/europace/euad122.257
- https://academic.oup.com/europace/article-pdf/25/Supplement_1/euad122.257/50428782/euad122.257.pdf
- OA Status
- hybrid
- Cited By
- 1
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4377983831
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4377983831Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/europace/euad122.257Digital Object Identifier
- Title
-
A novel workflow for advanced mapping of repolarization dispersion from endocardial unipolar electrograms in patients with coved-type brugada syndromeWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-05-24Full publication date if available
- Authors
-
S Latrofa, S Garibaldi, Shaiana Vilella Hartwig, Luca Panchetti, M S Morelli, N Martini, N Zaurino, G Mansi, Gianluca Mirizzi, Umberto Startari, Claudio Passino, Michele Emdin, Marcello Piacenti, Alberto Giannoni, Andrea RossiList of authors in order
- Landing page
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https://doi.org/10.1093/europace/euad122.257Publisher landing page
- PDF URL
-
https://academic.oup.com/europace/article-pdf/25/Supplement_1/euad122.257/50428782/euad122.257.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
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hybridOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/europace/article-pdf/25/Supplement_1/euad122.257/50428782/euad122.257.pdfDirect OA link when available
- Concepts
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Medicine, Brugada syndrome, Repolarization, Cardiology, Internal medicine, Endocardium, Electrical conduction system of the heart, Electrocardiography, ElectrophysiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
1Total citation count in OpenAlex
- Citations by year (recent)
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2024: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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| cited_by_percentile_year.max | 94 |
| cited_by_percentile_year.min | 90 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 15 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/17 |
| sustainable_development_goals[0].score | 0.47999998927116394 |
| sustainable_development_goals[0].display_name | Partnerships for the goals |
| citation_normalized_percentile.value | 0.57139221 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |