As part of the CBAC Seminar series, join us for this presentation by Michel Haïssaguerre, a Professor at the Victor-Segalen Bordeaux 2 University and head of the Cardiac Arrhythmia Department at Bordeaux University Hospital (Haut-Lévêque Cardiology Hospital), France.
This seminar will be virtual. Register for this event by going here.
Seminar Title: "New Insight on Unexplained Sudden Cardiac Death"
Abstract: Unexplained SCD (synonymous: Idiopathic ventricular fibrillation -IVF) is diagnosed in patients who survived a VF episode without any identifiable structural or electrical cause after extensive investigations. It is a common cause of sudden death in young adults <35 yrs, accounting for 31-35% of all SCD.
A systematic set of investigations is required to establish the diagnosis, as missing data in an individual may impact on his appropriate management.
Recent studies using higher resolution techniques have provided novel insights on the potential causes of unexplained SCD. Specifically a high incidence of microstructural cardiomyopathic areas can be found at the source of VF re-entries demonstrated by non-invasive ECGI mapping. These subclinical alterations require high-density endo- and epicardial mapping to be identified using electrogram criteria. Small areas are involved and located individually in various sites mostly epicardial. Their inconsistent characteristics suggest that a variety of genetic or acquired pathological processes affecting cellular connectivity or tissue structure could be involved in their genesis.
Purkinje abnormalities manifesting as triggering ectopy or providing a substrate for reentry represent a second important cause. The documentation of ephemeral Purkinje ectopy requires continuous ECG monitoring for diagnosis. A variety of diseases affecting Purkinje cell function or conduction are potentially at play in their pathogenesis.
Finally repolarization abnormalities detected by clinical dynamic manoeuvres or genetic analysis represent a third cause.
Deep phenotyping using comprehensive investigations can therefore allow the great majority of unexplained SCD to ultimately receive diagnoses of a cardiac disease, likely underlain by a mosaic of pathologies. Precise phenotypic characterization has also significant implications for interpretation of genetic variants, for the risk assessment and for individual therapy.
For more information, contact Huyen (Gwen) Nguyen at firstname.lastname@example.org
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