Electroanatomical voltage mapping with contact force sensing for diagnosis of arrhythmogenic right ventricular cardiomyopathy

• Published in: International journal of cardiology 2023-12, Vol.392, p.131289-131289, Article 131289
• Main Authors: Saguner, A.M., Lunk, D., Mohsen, M., Knecht, Sven, Akdis, Deniz, Costa, S., Gasperetti, A., Duru, F., Rossi, V.A., Brunckhorst, C.B.
• Format: Article
• Language: English
• Subjects: Arrhythmogenic right ventricular cardiomyopathy; Arrhythmogenic right ventricular dysplasia; Contact force; Electroanatomical voltage mapping
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2023.131289

Three-dimensional electroanatomical mapping (EAM) can be helpful to diagnose arrhythmogenic right ventricular cardiomyopathy (ARVC). Yet, previous studies utilizing EAM have not systematically used contact-force sensing catheters (CFSC) to characterize the substrate in ARVC, which is the current gold standard to assure adequate tissue contact. To investigate reference values for endocardial right ventricular (RV) EAM as well as substrate characterization in patients with ARVC by using CFSC. Endocardial RV EAM during sinus rhythm was performed with CFSC in 12 patients with definite ARVC and 5 matched controls without structural heart disease. A subanalysis for the RV outflow tract (RVOT), septum, free-wall, subtricuspid region, and apex was performed. Endocardial bipolar and unipolar voltage amplitudes (BVA, UVA), signal characteristics and duration as well as the impact of catheter orientation on endocardial signals were also investigated. ARVC patients showed lower BVA vs. controls (p = 0.018), particularly in the subtricuspid region (1.4, IQR:0.5–3.1 vs. 3.8, IQR:2.5-5 mV, p = 0.037) and RV apex (2.5, IQR:1.5–4 vs. 4.3,IQR:2.9–6.1 mV, p = 0.019). BVA in all RV regions yielded a high sensitivity and specificity for ARVC diagnosis (AUC 59–78%, p