EP Fellows Curriculum: Nonischemic Cardiomyopathy-Nonischemic Cardiomyopathy

Video Transcription

Video Summary

In patients with non-ischemic cardiomyopathy and ventricular arrhythmias, it is important to determine the underlying etiology of the cardiomyopathy and assess the severity of left ventricular dysfunction. Genetic causes should be considered as about 40% of patients have a genetic mutation associated with the condition. Inflammatory diseases such as sarcoidosis should also be evaluated. Imaging modalities like MRI are useful in detecting areas of fibrosis and can help guide further treatment. Voltage maps and electrogram characteristics can help localize the specific scar locations and guide ablation procedures. The presence and distribution of scar can vary depending on the underlying etiology and can help differentiate between different conditions. Scar in the basal septum, basal LV free wall, and along the annulus of the aortic or mitral valves is common in non-ischemic cardiomyopathy. The success rates for ablation procedures can vary depending on the location and extent of scar tissue. Patients with non-ischemic cardiomyopathy should be regularly monitored and managed with optimal medical therapy in addition to any necessary ablation procedures. Overall, it is important to evaluate for the underlying cause of the cardiomyopathy and address any treatable factors to improve outcomes for these patients.

Keywords

non-ischemic cardiomyopathy

ventricular arrhythmias

underlying etiology

left ventricular dysfunction

genetic causes

inflammatory diseases

sarcoidosis

MRI imaging

fibrosis detection

ablation procedures