Arrhythmogenic right ventricular cardiomyopathy associated ventricular tachycardia misdiagnosed as idiopathic right ventricular outflow tract origin and its management

Xiangmin Shi, Yutang Wang, Zhaoliang Shan

Department of Cardiology, The General Hospital of People’s Liberation Army, Beijing, China;.

DOI: 10.4236/crcm.2013.28121                

Abstract

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is an autosomal dominant genetic form of cardiomyopathy (CM), which primarily affects the right ventricle (RV) and results in life threatening ventricular arrhythmias and sudden cardiac death (SCD). Diagnosis is difficult due to the broad spectrum of phenoltypic variations, especially in the early stage. Clinical suspicion should be raised in the setting of refractory ventricular tachycardia originating from the RV, and the final diagnosis could be made based on the combination of electrocardiography, echocardiography, cardiac magnetic resonance imaging (CMRI) and myocardial biopsy. Implantable cardioverter-defibrillator (ICD) implantation is an effective option for the treatment of ARVC.

Keywords

Arrhythmogenic Right Ventricular Cardiomyopathy; Ventricular Tachycardia; Cardiac Magnetic Resonance Imaging

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Dimitrios, A., Nikos P, Angeliki, A., et al. (2011) Arrhythmogenic right ventricular cardiomyopathy/dysplasia. The Hellenic Journal of Cardiology, 52, 452-461
[2]	McKenna, W.J., Thiene, G., Nava, A., et al., Task Force of the Working Group Myocardial and Pericardial Disease of the European Society of Cardiology and of the Scientific Council on Cardiomyopathies of the International Society and Federation of Cardiology (1994) Diagnosis of arrhythmogenic right ventricular dysplasia/ cardiomyopathy. British Heart Journal, 71, 215-218. http://dx.doi.org/10.1136/hrt.71.3.215
[3]	O’Donnell, D., Cox, D., Bourke, J., et al. (2003) Clinical and electrophysiological differences between patients with arrhythmogenic right ventricular dysplasia and right ventricular outflow tract tachycardia. European Heart Journal, 24, 801-810. http://dx.doi.org/10.1016/S0195-668X(02)00654-1
[4]	Daniel, P., Morin, M., Andreas, C., et al. (2010) Usefulness of precordial T-Wave inversion to distinguish arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia arising from the right ventricular outflow tract. American Journal of Cardiology, 105, 1821-1824. http://dx.doi.org/10.1016/j.amjcard.2010.01.365
[5]	Nasir, K., Bomma, C., Tandri, H., et al. (2004) Electrocardiographic features of arrhythmogenic right ventricular dysplasia/cardiomyopathy according to disease severity: A need to broaden diagnostic criteria. Circulation, 110, 1527-1534. http://dx.doi.org/10.1161/01.CIR.0000142293.60725.18
[6]	Marcus, F., McKenna, W., Sherrill, D., et al. (2009) Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D): Proposed modification of the task force criteria. Circulation, in Press.
[7]	Khang, L., Colin, E., Hamish, H., et al. (2012) Utility of cardiac magnetic resonance in the evaluation of unselected patients with possible arrhythmogenic right ventricular cardiomyopathy. Clinical Medicine Insights: Cardiology, 6, 153-162.
[8]	Giovanni, Q., Syed, I., Andrew, S., et al. (2013) Arrhythmogenic right ventricular cardiomyopathy mimics: role of cardiovascular magnetic resonance. Journal of Cardiovascular Magnetic Resonance, 15, 16. http://dx.doi.org/10.1186/1532-429X-15-16
[9]	Nasir, K., Bomma, C., Tandri, H., et al. (2004) Electrocardiographic features of arrhythmogenic right ventricular dysplasia/cardiomyopathy according to disease severity: A need to broaden diagnostic criteria. Circulation, 110, 1527-1534. http://dx.doi.org/10.1161/01.CIR.0000142293.60725.18