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Electrophysiology Predicts Tachycardia After Heart Failure

Differences in electrophysiology observed in scarred areas, according to study

THURSDAY, May 28 (HealthDay News) -- Patients with ischemic cardiomyopathy who go on to develop ventricular tachycardia have differences in the electrophysiology and electroanatomy of the scarred areas, according to a study published online May 27 in the Journal of the American College of Cardiology.

Haris M. Haqqani, and colleagues from the University of Melbourne in Australia performed detailed electroanatomic mapping of the left ventricular endocardium in 17 patients with stable ischemic cardiomyopathy and 17 patients with ischemic cardiomyopathy and spontaneous sustained monomorphic ventricular tachycardia.

The researchers found that the stable ischemic cardiomyopathy patients had markedly smaller total low-voltage areas, lower scar-related electrogram density, and fewer fractionated, isolated, and very late potentials. In contrast, the authors note, more patients who developed ventricular tachycardia had electrograms that were fractionated or exhibited either isolated or very late potentials, as well as potential conducting channels within the dense scar next to the mitral annulus.

The data "reinforces earlier findings correlating propensity to ventricular tachycardia, with scarred regions harboring surviving isolated myocardial bundles from the pathologist's perspective and fractionated, isolated electrograms as seen by the electrophysiologist," James P. Daubert, M.D., from Duke University Medical Center in Durham, N.C., writes in an accompanying editorial.

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