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. 2023 Apr 21;25(Suppl B):B123–B125. doi: 10.1093/eurheartjsupp/suad090

Figure 1.

Figure 1

Example of abnormal epicardial ventricular electrograms typically discovered in patients with inherited cardiogenetic diseases [Brugada syndrome (BrS), long-QT syndrome (LQTS), and early repolarization syndrome (ERS)], treated in our institution. Left panel shows an example of epicardial mapping in a LQTS patient. The abnormal signals present a low amplitude (<1.5 mV, bipolar voltage) and are characterized by multiple fragmented and double components. The multiple components could be the expression of local conduction delay and lines of block. The distribution of abnormal signals extended from the epicardial RVOT to the infero-lateral peritricuspid region including the anterior wall. Middle panel shows an example of epicardial mapping in a BrS patient. The potential duration map identifies an area exhibiting delayed and prolonged signals. These electrical abnormalities show a concentric ‘onion-like’ distribution in the RVOT and anterior epicardial wall. Traditionally, the core region displays the most delayed electrical activity (most prolonged signal in DNAV 5–6), with a less prolongation degree at the periphery (less prolonged activity in DNAV 3–4, 1–2, and 7–8; normal signal in DNAV 9–10). Right panel shows an example of epicardial mapping in an ERS patient. The anterior wall of the epicardial RV exhibits low-amplitude (<1 mV) and fragmented abnormal electrograms. These regions may harbour microstructural abnormalities and fibrosis ultimately causing the low-voltage and the electrogram fractionation.