Ventricular Tachycardia in the Setting of Chagasic Cardiomyopathy

Abstract

CC causes a unique ventricular tachycardia substrate concentrated to the basal lateral LV, with marked epicardial predominance. The scar pattern is particularly dense and transmural as compared with the more erratic/patchy scar patterns seen in other nonischemic cardiomyopathies. Endocardial unipolar voltage mapping serves to characterize epicardial scar in this setting.

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

“…CMR-defined scar remains the gold standard for precise demarcation of scar and is preferable over unipolar voltage mapping for defining scar. Furthermore, cutoff values are impacted by electrode size, wall thickness, surrounding anatomical structures, and ventricular hypertrophy, or are region specific ( S8.5.2.16 , S8.5.2.18 , S8.5.2.26 , S8.5.2.28 ).…”

Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023

“…Além disso, o mapeamento endocárdico e/ou epicárdico tem demonstrado a presença de eletrogramas diastólicos anormais, pré-sistólicos e mesodiastólicos, predominando nas regiões de acinesia ou discinesia do VE. 481 , 776 , 778 , 780 , 781 …”

Ventricular arrhythmias. Ventricular tachycardias and sudden cardiac death. 2020 Clinical guidelines

“…ЕОК IIbC (УУР С, УДД 4) Болезнь Чагаса • Имплантация ИКД*** рекомендована у пациентов с болезнью Чагаса и ФВ ЛЖ <40%, при ожидаемой продолжительности жизни >1 года с хорошим функциональным статусом [31,[253][254][255]419].…”