Arrhythmogenic Right Ventricular Cardiomyopathy: Usefulness of Imaging in Prognostic Stratification and Choice of Treatment


Subgroups

Risk markers

Recommendations

Follow-up

ICD indication

Definite ARVC: high risk

Aborted SD

Reduce physical exercise

Annually, including:

Recommended

Sustained VT

Avoid competitive sport

 Electrocardiography

Unexplained syncope

β-blockers

 Cardiac imaging (echocardiography vs. CMR)

 Holter

 Exercise stress testing

Definite ARVC: moderate risk

Extensive disease (severe RV dysfunction, large LV involvement)

Reduce physical exercise

Annually including:

Consider

Nonsustained VT

Avoid competitive sport

 Electrocardiography

β-blockers

 Cardiac imaging (echocardiography vs. CMR)

 Holter

 Exercise stress testing

Definite ARVC: low risk

Remaining patients with definite diagnosis of ARVC

Reduce physical exercise

Annually including:

Not recommended

Avoid competitive sport

 Electrocardiography

β-blockers

 Cardiac imaging (echocardiography vs. CMR)

 Holter

 Exercise stress testing

Asymptomatic mutation carriers

Asymptomatic mutation-carrying relatives of ARVC

Reduce physical exercise

Annually including:

Not recommended

Avoid competitive sport

 Electrocardiography

 Cardiac imaging (echocardiography vs. CMR)

 Holter

 Exercise stress testing


Modified from Epstein et al. [3]

CMR cardiac magnetic resonance, LV left ventricle, RV right ventricle, SD sudden death, VT ventricular tachycardia





References



1.

Marcus FI, Fontaine GH, Guiraudon G, Frank R, Laurenceau JL, Malergue C, Grosgogeat Y (1982) Right ventricular dysplasia: a report of 24 adult cases. Circulation 65(2):384–398PubMedCrossRef


2.

Hauer RN, Aliot E, Block M, Capucci A, Luderitz B, Santini M, Vardas PE (2001) Indications for implantable cardioverter defibrillator (ICD) therapy. Study Group on Guidelines on ICDs of the Working Group on Arrhythmias and the Working Group on Cardiac Pacing of the European Society of Cardiology. Eur Heart J 22(13):1074–1081. doi:10.​1053/​euhj.​2001.​2584 PubMedCrossRef


3.

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Mar 14, 2016 | Posted by in CARDIOVASCULAR IMAGING | Comments Off on Arrhythmogenic Right Ventricular Cardiomyopathy: Usefulness of Imaging in Prognostic Stratification and Choice of Treatment
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