Electroanatomic mapping of arrhythmogenic right ventricular dysplasia
Munther Boulos, MDa,
Ilan Lashevsky, MDa,
Shimon Reisner, MDa and
Lior Gepstein, MD, PhD*,*
* Cardiology Department, Rambam Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Figure 1 A representative RV electroanatomic voltage map from one of the control subjects; the right anterior oblique projection is shown. The colors represent the amplitude of the local unipolar electrogram. Note the normal unipolar voltage values (blue and purple) throughout the RV. LA = left atrium; RA = right atrium.
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Figure 2 Echocardiographic and electroanatomic mapping of the RV in one of the patients with ARVD. A, Two-dimensional echocardiographic apical view of Patient 2. Note the severe enlargement of the RV and atrium. B, Anteroposterior (left) and left anterior oblique (right) views of the RV unipolar voltage maps of the same patient. Note the extensive area of low voltage (red indicates <2 mV) in the apex and anterolateral free wall, with the septum being spared (purple indicates >5 mV). LA = left atrium; RA = right atrium; RVOT = right ventricular outflow tract.
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Figure 3 Another example of a patient in the ARVD group. The electroanatomic maps, shown from the right anterior oblique view, depict the three-dimensional spatial dispersion of the unipolar electrogram’s amplitude (left panel), duration (middle panel) and amplitude/duration ratio (right panel). Note that the dysplastic region (red area in the maps) can be identified by the electrogram’s abnormally low amplitude (red indicates <3 mV), prolonged duration (red indicates >85 ms) and low amplitude/duration ratio (red indicates <0.05).
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