Document Detail


Late potentials and ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy.
MedLine Citation:
PMID:  10215287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied 38 patients (mean age 32 +/- 14 years) with arrhythmogenic right ventricular cardiomyopathy (ARVC) to evaluate the clinical significance of histologic features on endomyocardial biopsy specimens as related to signal-averaged electrocardiography (SAECG), spontaneous ventricular arrhythmias, and hemodynamic features. Fifteen patients presented with ventricular tachycardia or fibrillation (sustained ventricular arrhythmias), 23 with other minor arrhythmias. SAECG variables and right ventricular ejection fraction (RVEF) were statistically correlated with the extent of myocardial fibrosis on biopsy in ARVC. An increased percentage of fibrous tissue (> or = 30%) was a significant univariate predictor of late potentials (p = 0.004) and reduced RVEF (p = 0.02). The 18 patients with late potentials had an increased percentage of fibrous tissue (p = 0.01), a reduced RVEF (p = 0.0004), and a higher risk for sustained ventricular arrhythmias (p = 0.05) than the 20 patients without late potentials. RVEF was the most powerful predictor of late potentials (p = 0.004) at multivariate analysis. Moreover, RVEF < or = 50% was associated with an increased risk for development of sustained ventricular arrhythmias (p = 0.02). A SAECG parameter, namely the root-mean-square voltage of the terminal 40 ms at 25 Hz, was an independent predictive factor for the occurrence of sustained ventricular arrhythmias (p = 0.02). Although fibrous tissue may contribute to delayed myocardial activation in ARVC, a reduced RVEF plays an essential role for spontaneous manifestation of sustained ventricular arrhythmias.
Authors:
P Turrini; A Angelini; G Thiene; G Buja; L Daliento; G Rizzoli; A Nava
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  83     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-17     Completed Date:  1999-05-17     Revised Date:  2012-02-22    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1214-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, University of Padua Medical School, Padova, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arrhythmogenic Right Ventricular Dysplasia / complications,  diagnosis,  physiopathology*
Biopsy
Child
Coronary Angiography
Echocardiography
Electrocardiography*
Female
Fibrosis / pathology
Heart Ventricles / pathology,  physiopathology,  ultrasonography
Humans
Male
Middle Aged
Prognosis
Stroke Volume
Tachycardia, Ventricular / complications,  diagnosis,  physiopathology*
Grant Support
ID/Acronym/Agency:
E.0743//Telethon

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