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Disease-specific electrocardiographic lead positioning for early diagnosis of arrhythmogenic right ventricular cardiomyopathy : to improve early diagnosis in plakophilin-2 pathogenic variant carriers

Ruisch, Janna (2020) Disease-specific electrocardiographic lead positioning for early diagnosis of arrhythmogenic right ventricular cardiomyopathy : to improve early diagnosis in plakophilin-2 pathogenic variant carriers.

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Abstract:Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited disease characterized by replacement of cardiomyocytes by fibrofatty tissue which can lead to heart failure or sudden cardiac death. Genetic defects in desmosomal proteins, with plakophilin-2 (PKP2) being most frequently affected, contribute to disease development. Early detection of electrical abnormalities might be aided by properly placed electrocardiographic (ECG) leads. This study aims to identify a better lead configuration to early detect ECG changes in PKP2-pathogenic variant carriers. 67-lead body surface potential maps were obtained in ARVC patients (n=7), PKP2-pathogenic variant carriers (n=16) and control subjects without signs of structural heart disease (n=9). In these groups, (1) temporal and spatial distribution of integrals in ARVC patients, (2) spatial distribution of diagnostic ECG criteria of ARVC, and (3) additional information about mean cardiac activation pathway through the cardiac anatomy, were investigated. Additional lead locations and ECG criteria suggest to be a potential benefit in the early detection of ARVC. Disease manifestation was identified solely on depolarization characteristics, particularly in the initial depolarization segment, whereas the repolarization segment showed not to include additional information for detection of disease manifestation. Future research requires long-term monitoring to relate the additional depolarization criteria with onset of disease manifestation.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/84367
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