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Catheter ablation of ventricular arrhythmias in left ventricular noncompaction cardiomyopathy

  • Author Footnotes
    1 The first and second authors contributed equally to this manuscript.
    Juan José Sánchez Muñoz
    Correspondence
    Address reprint requests and correspondence: Dr, Juan José Sánchez Muñoz, C/ Periodista Antonio Herrero, 25 B, Esc. 6, 3° M, 30007 Murcia, Spain.
    Footnotes
    1 The first and second authors contributed equally to this manuscript.
    Affiliations
    Arrhythmia Unit and Electrophysiology, Department of Cardiology, Virgen de la Arrixaca University Hospital, Murcia, Spain

    Inherited Cardiac Disease Unit, Department of Cardiology, Virgen de la Arrixaca University Hospital, European Reference Networks (Guard-Heart), European Commission, Brusels, Belgium

    Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain

    Red de Investigación Cardiovascular (CIBERCV) Instituto de Salud Carlos III, Spain
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  • Author Footnotes
    1 The first and second authors contributed equally to this manuscript.
    Carmen Muñoz-Esparza
    Footnotes
    1 The first and second authors contributed equally to this manuscript.
    Affiliations
    Arrhythmia Unit and Electrophysiology, Department of Cardiology, Virgen de la Arrixaca University Hospital, Murcia, Spain

    Inherited Cardiac Disease Unit, Department of Cardiology, Virgen de la Arrixaca University Hospital, European Reference Networks (Guard-Heart), European Commission, Brusels, Belgium

    Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain

    Red de Investigación Cardiovascular (CIBERCV) Instituto de Salud Carlos III, Spain
    Search for articles by this author
  • Pablo Peñafiel Verdú
    Affiliations
    Arrhythmia Unit and Electrophysiology, Department of Cardiology, Virgen de la Arrixaca University Hospital, Murcia, Spain

    Inherited Cardiac Disease Unit, Department of Cardiology, Virgen de la Arrixaca University Hospital, European Reference Networks (Guard-Heart), European Commission, Brusels, Belgium

    Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain

    Red de Investigación Cardiovascular (CIBERCV) Instituto de Salud Carlos III, Spain
    Search for articles by this author
  • Juan Martínez Sánchez
    Affiliations
    Arrhythmia Unit and Electrophysiology, Department of Cardiology, Virgen de la Arrixaca University Hospital, Murcia, Spain

    Inherited Cardiac Disease Unit, Department of Cardiology, Virgen de la Arrixaca University Hospital, European Reference Networks (Guard-Heart), European Commission, Brusels, Belgium

    Red de Investigación Cardiovascular (CIBERCV) Instituto de Salud Carlos III, Spain
    Search for articles by this author
  • Francisco García Almagro
    Affiliations
    Arrhythmia Unit and Electrophysiology, Department of Cardiology, Virgen de la Arrixaca University Hospital, Murcia, Spain

    Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
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  • Ginés Elvira Ruiz
    Affiliations
    Arrhythmia Unit and Electrophysiology, Department of Cardiology, Virgen de la Arrixaca University Hospital, Murcia, Spain

    Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain

    Red de Investigación Cardiovascular (CIBERCV) Instituto de Salud Carlos III, Spain
    Search for articles by this author
  • Juan Ramón Gimeno Blanes
    Affiliations
    Inherited Cardiac Disease Unit, Department of Cardiology, Virgen de la Arrixaca University Hospital, European Reference Networks (Guard-Heart), European Commission, Brusels, Belgium

    Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain

    Red de Investigación Cardiovascular (CIBERCV) Instituto de Salud Carlos III, Spain
    Search for articles by this author
  • Arcadio García Alberola
    Affiliations
    Arrhythmia Unit and Electrophysiology, Department of Cardiology, Virgen de la Arrixaca University Hospital, Murcia, Spain

    Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain

    Red de Investigación Cardiovascular (CIBERCV) Instituto de Salud Carlos III, Spain
    Search for articles by this author
  • Author Footnotes
    1 The first and second authors contributed equally to this manuscript.
Published:December 17, 2020DOI:https://doi.org/10.1016/j.hrthm.2020.12.014

      Background

      There are limited data on ventricular arrhythmias (VAs) associated with left ventricular noncompaction (LVNC) cardiomyopathy.

      Objectives

      This study aims to analyze the clinical and electrocardiographic characteristics of VAs in a group of patients with LVNC.

      Methods

      Forty-two nonrelated patients with LVNC and VAs were included that were evaluated at the Inherited Cardiac Disease Unit of the University Hospital Virgen Arrixaca (Murcia-Spain) (ERN Guard-Heart Centre, European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart).

      Results

      Thirteen patients (30.9%) had isolated LVNC, 27 (64.3%) had LVNC associated with dilated cardiomyopathy, and 2 (4.8%) had LVNC associated with hypertrophic cardiomyopathy. Among isolated LVNC individuals, 9 (69.2%) had premature ventricular complexes (PVCs)/nonsustained ventricular tachycardias (VTs), and 4 (30.8%) VTs (1 VT degenerating in ventricular fibrillation). In the dilated cardiomyopathy group, 11 (40.7%) patients had PVCs, 14 (51.9%) VTs, and 2 (7.4%) ventricular fibrillation. In the hypertrophic cardiomyopathy group, one patient had PVCs and the other VTs. Endocardial mapping and ablation were performed in 19 patients (45.2%): 7 ventricular outflow tracts (4 right ventricular outflow tract, 1 left coronary cusp, and 2 right coronary cusp), 2 in the left ventricular summit, 5 related to Purkinje potentials at the mid inferoseptal area, and 5 associated with endocardial scar localized in the basal anterolateral and inferolateral segments. Epicardial ablation was performed in 3 cases.

      Conclusion

      The substrate of VAs in LVNC cardiomyopathy is heterogeneous, with origin in ventricular outflow tracts, Purkinje system related, and resembling scar patterns in nonischemic cardiomyopathy.

      Keywords

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