Signal-averaged electrocardiogram in Ebstein's anomaly.

摘要: We sought to establish pathogenetic links between electrophysiology, histopathology, and ventricular tachyarrhythmias in patients with Ebstein's anomaly. The atrialized right ventricle (ARV) is the site of mechanically inducible tachyarrhythmias, but relations arrhythmogenic substrate, type trigger(s) have not been established. This study comprised 23 (10 men 13 women; aged 18 58 years; mean 32 ± 3) who did undergo surgery 6 pre- postoperative anomaly, diagnosed by transthoracic transesophageal echocardiography. Twenty-one had classic anomaly 2 mild forms. Signal-averaged electrocardiograms (SAECGs) identified slow conduction using 3 time-domain variables calculated an automated algorithm inspected visually. Two were required presence late potentials. SAECGs repeated after surgical exclusion ARV. Five specimens ARV true atrium examined histologically. Mathematic simulations used illustrate anchored unanchored spiral/scroll waves. positive 21 negative postoperatively so studied. was characterized histologically clusters cardiomyocytes isolated within a fibrous matrix. hypothesize that identify residing ARV, excitation this substrate provokes waves cannot anchor because are meander erratically as polymorphic tachycardia or break up into fibrillation.