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Serial reevaluation for ARVD/C is indicated in patients presenting with left bundle branch block ventricular tachycardia and minor ECG abnormalities.
J Cardiovasc Electrophysiol. 2006 Jun; 17(6):586-93.JC

Abstract

INTRODUCTION

Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is based on a set of criteria proposed by the International Task Force (TF) for Cardiomyopathies in 1994. To fulfill these criteria, presence of both electrocardiographic and anatomical abnormalities must be assessed with ECG and imaging techniques, respectively. This may be difficult in patients with early/mild forms of the disease as detectable structural abnormalities may still be absent. We evaluated in which patients presenting with right ventricular tachycardia (VT) serial reevaluation for ARVD/C is indicated.

METHODS AND RESULTS

Sixty consecutive patients (41 men, mean age 40+/-15 years) were evaluated by the TF criteria for possible ARVD/C because of presentation with a left bundle branch block (LBBB) VT, representing 1 minor criterion. The presence on the ECG of a T-wave inversion beyond lead V2 (1 minor), right precordial QRS prolongation (1 major), or an epsilon wave (1 major) was assessed together with the visualization of severe regional/global right ventricle dysfunction (1 major) or mild segmental dilatation/regional hypokinesia (1 minor) by standard imaging techniques. Initially, 22 (37%) patients were diagnosed as having ARVD/C. After 47+/-39 (range 6-146) months, 23 initially TF-negative patients were reevaluated because of recurrent symptoms, with 12 (52%) additional patients now meeting the TF criteria. Eleven of these 12 (92%) patients presented initially with ECG abnormalities only, but developed structural abnormalities on imaging at follow-up.

CONCLUSION

ECG abnormalities may precede structural abnormalities warranting serial reevaluation for ARVD/C in initially TF-negative patients presenting with LBBB VT with only ECG abnormalities.

Authors+Show Affiliations

Leiden University Medical Center, Leiden, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16836703

Citation

Kiès, Philippine, et al. "Serial Reevaluation for ARVD/C Is Indicated in Patients Presenting With Left Bundle Branch Block Ventricular Tachycardia and Minor ECG Abnormalities." Journal of Cardiovascular Electrophysiology, vol. 17, no. 6, 2006, pp. 586-93.
Kiès P, Bootsma M, Bax JJ, et al. Serial reevaluation for ARVD/C is indicated in patients presenting with left bundle branch block ventricular tachycardia and minor ECG abnormalities. J Cardiovasc Electrophysiol. 2006;17(6):586-93.
Kiès, P., Bootsma, M., Bax, J. J., Zeppenfeld, K., van Erven, L., Wijffels, M. C., van der Wall, E. E., & Schalij, M. J. (2006). Serial reevaluation for ARVD/C is indicated in patients presenting with left bundle branch block ventricular tachycardia and minor ECG abnormalities. Journal of Cardiovascular Electrophysiology, 17(6), 586-93.
Kiès P, et al. Serial Reevaluation for ARVD/C Is Indicated in Patients Presenting With Left Bundle Branch Block Ventricular Tachycardia and Minor ECG Abnormalities. J Cardiovasc Electrophysiol. 2006;17(6):586-93. PubMed PMID: 16836703.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serial reevaluation for ARVD/C is indicated in patients presenting with left bundle branch block ventricular tachycardia and minor ECG abnormalities. AU - Kiès,Philippine, AU - Bootsma,Marianne, AU - Bax,Jeroen J, AU - Zeppenfeld,Katja, AU - van Erven,Lieselot, AU - Wijffels,Maurits C, AU - van der Wall,Ernst E, AU - Schalij,Martin J, PY - 2006/7/14/pubmed PY - 2006/12/9/medline PY - 2006/7/14/entrez SP - 586 EP - 93 JF - Journal of cardiovascular electrophysiology JO - J Cardiovasc Electrophysiol VL - 17 IS - 6 N2 - INTRODUCTION: Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is based on a set of criteria proposed by the International Task Force (TF) for Cardiomyopathies in 1994. To fulfill these criteria, presence of both electrocardiographic and anatomical abnormalities must be assessed with ECG and imaging techniques, respectively. This may be difficult in patients with early/mild forms of the disease as detectable structural abnormalities may still be absent. We evaluated in which patients presenting with right ventricular tachycardia (VT) serial reevaluation for ARVD/C is indicated. METHODS AND RESULTS: Sixty consecutive patients (41 men, mean age 40+/-15 years) were evaluated by the TF criteria for possible ARVD/C because of presentation with a left bundle branch block (LBBB) VT, representing 1 minor criterion. The presence on the ECG of a T-wave inversion beyond lead V2 (1 minor), right precordial QRS prolongation (1 major), or an epsilon wave (1 major) was assessed together with the visualization of severe regional/global right ventricle dysfunction (1 major) or mild segmental dilatation/regional hypokinesia (1 minor) by standard imaging techniques. Initially, 22 (37%) patients were diagnosed as having ARVD/C. After 47+/-39 (range 6-146) months, 23 initially TF-negative patients were reevaluated because of recurrent symptoms, with 12 (52%) additional patients now meeting the TF criteria. Eleven of these 12 (92%) patients presented initially with ECG abnormalities only, but developed structural abnormalities on imaging at follow-up. CONCLUSION: ECG abnormalities may precede structural abnormalities warranting serial reevaluation for ARVD/C in initially TF-negative patients presenting with LBBB VT with only ECG abnormalities. SN - 1045-3873 UR - https://www.unboundmedicine.com/medline/citation/16836703/Serial_reevaluation_for_ARVD/C_is_indicated_in_patients_presenting_with_left_bundle_branch_block_ventricular_tachycardia_and_minor_ECG_abnormalities_ L2 - https://doi.org/10.1111/j.1540-8167.2006.00442.x DB - PRIME DP - Unbound Medicine ER -