Serial reevaluation for ARVD/C is indicated in patients presenting with left bundle branch block ventricular tachycardia and minor ECG abnormalities.

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 b...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 17; no. 6; pp. 586 - 594
Autores principales: Kiès P, Bootsma M, Bax JJ, Zeppenfeld K, Van Erven L, Wijffels MC, Van Der Wall EE, Schalij MJ
Formato: diagnostic images research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Jun2006
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Journal of Cardiovascular Electrophysiology
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      dt: Jun2006
      vid: 17
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        106169466
        2009319529
        10.1111/j.1540-8167.2006.00442.x
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        atl: Serial reevaluation for ARVD/C is indicated in patients presenting with left bundle branch block ventricular tachycardia and minor ECG abnormalities.
      aug:
        au:
          Kiès P
          Bootsma M
          Bax JJ
          Zeppenfeld K
          Van Erven L
          Wijffels MC
          Van Der Wall EE
          Schalij MJ
        affil: Leiden University Medical Center, Leiden, Netherlands
      sug:
        subj:
          Arrhythmogenic Right Ventricular Dysplasia Therapy
          Myocardial Diseases Therapy
          Adult
          Female
          Male
          Middle Age
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: 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.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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