Incremental value of the signal-averaged ECG for diagnosing arrhythmogenic cardiomyopathy

Pearman, Charles M.; Lee, David; Davies, Brianna; Khan, Habib; Tadros, Rafik; Cadrin‐Tourigny, Julia; Roberts, Jason D.; Sanatani, Shubhayan; Simpson, Christopher S.; Angaran, Paul; Hansom, Simon; Ilhan, Erkhan; Seifer, Colette; Green, Martin A.; Gardner, Martin J.; Talajic, Mario; Laksman, Zachary; Healey, Jeff S.; Krahn, Andrew D.

doi:10.1016/j.hrthm.2022.10.005

Cited by 6 publications

(4 citation statements)

References 17 publications

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“… 79 An abnormal SAECG is more often seen in severe disease and is associated with underlying structural abnormalities. 87 In this study by Pearman et al, genotype positive and minimal phenotype patients had SAECG findings similar to healthy subjects, indicating that abnormalities are more likely seen when structural abnormalities are detectable and disease has progressed. 87 Similar to Epsilon waves, other criteria to diagnose AC are usually present by the time the SAECG findings become abnormal.…”

Section: Diagnosismentioning

confidence: 56%

“…82,85 The signal averaged ECG (SAECG) is done over multiple recorded cardiac cycles in an attempt to maximize the ECG signal to noise ratio and identify ECG features undetectable by standard techniques, including late potentials. 87 The 2010 TFC includes SAECG as a minor criterion if at least 1 of 3 parameters are met including: filtered QRS duration ≥114 ms, duration of terminal QRS <40 µV ≥38 ms, and a root-mean-square voltage of terminal 40 ms of ≤20 µV. 79 An abnormal SAECG is more often seen in severe disease and is associated with underlying structural abnormalities.…”

Section: Dovepressmentioning

confidence: 99%

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The Many Faces of Arrhythmogenic Cardiomyopathy: An Overview

Tadros,

Miyake,

Kearney

et al. 2023

TACG

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Arrhythmogenic cardiomyopathy (AC) is a disease that involves electromechanical uncoupling of cardiomyocytes. This leads to characteristic histologic changes that ultimately lead to the arrhythmogenic clinical features of the disease. Initially thought to affect the right ventricle predominantly, more recent data show that it can affect both the ventricles or the left ventricle alone. Throughout the recent era, diagnostic modalities and criteria for AC have continued to evolve and our understanding of its clinical features in different age groups as well as the genotype to the phenotype correlations have improved. In this review, we set out to detail the epidemiology, etiologies, presentations, evaluation, and management of AC across the age continuum.

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Section: Diagnosismentioning

confidence: 56%

Section: Dovepressmentioning

confidence: 99%

The Many Faces of Arrhythmogenic Cardiomyopathy: An Overview

Tadros,

Miyake,

Kearney

et al. 2023

TACG

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“…The presence of more than 500 PVCs or ventricular arrhythmias with RBBB morphology at rest or during exercise is classified as a minor diagnostic criterion due to the low specificity [17]. Exercise-related ventricular arrhythmias can also be induced by other conditions, such as catecholaminergic polymorphic ventricular tachycardia or ischemic heart disease [17,55]. It should be noted that idiopathic 'fascicular' arrhythmias, which are characterized by a typical morphology of RBBB and narrow QRS, are not considered a criterion for the diagnosis of ALVC.…”

Section: Holter Ecg and Signal-avereraged Ecgmentioning

confidence: 99%

“…It should be noted that idiopathic 'fascicular' arrhythmias, which are characterized by a typical morphology of RBBB and narrow QRS, are not considered a criterion for the diagnosis of ALVC. Late potentials on signal-averaged electrocardiogram (SAECG) are no longer considered a standard diagnostic tool due to their diminished diagnostic accuracy when compared to contemporary tests [16,55]. However, SAECG may have a potential role in risk stratification for ACM and could be used to identify potentially arrhythmogenic ventricular scars [17].…”

Section: Holter Ecg and Signal-avereraged Ecgmentioning

confidence: 99%

Arrhythmogenic Left Ventricular Cardiomyopathy: From Diagnosis to Risk Management

Mauriello,

Roma,

Ascrizzi

et al. 2024

JCM

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Purpose of Review: Left ventricular arrhythmogenic cardiomyopathy (ALVC) is a rare and poorly characterized cardiomyopathy that has recently been reclassified in the group of non-dilated left ventricular cardiomyopathies. This review aims to summarize the background, diagnosis, and sudden cardiac death risk in patients presenting this cardiomyopathy. Recent Findings: Although there is currently a lack of data on this condition, arrhythmogenic left ventricular dysplasia can be considered a specific disease of the left ventricle (LV). We have collected the latest evidence about the management and the risks associated with this cardiomyopathy. Summary: Left ventricular arrhythmogenic cardiomyopathy is still poorly characterized. ALVC is characterized by fibrofatty replacement in the left ventricular myocardium, with variable phenotypic expression. Diagnosis is based on a multiparametric approach, including cardiac magnetic resonance (CMR) and genetic testing, and is important for sudden cardiac death (SCD) risk stratification and management. Recent guidelines have improved the management of left ventricular arrhythmogenic cardiomyopathy. Further studies are necessary to improve knowledge of this cardiomyopathy.

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