Document Detail


Malignant Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy with a Normal 12-Lead Electrocardiogram: A Rare but Under Recognized Clinical Entity.
MedLine Citation:
PMID:  23816439     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: In Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C), a normal electrocardiogram (ECG) is considered reassuring. However, some ARVD/C patients with ventricular arrhythmias have a normal ECG.
OBJECTIVES: 1) To estimate how often ARVD/C patients with ventricular arrhythmias have a normal ECG during sinus rhythm; and 2) To provide a clinical profile of these patients.
METHODS: We included 145 ARVD/C patients with a documented sustained ventricular arrhythmia. Conventional 12-lead sinus rhythm ECGs within six months of the event were reviewed for diagnostic Task Force Criteria (TFC). ECGs were classified as abnormal (≥1 TFC), non-specific (abnormal, no TFC) or normal. Cardiologic investigations within six months of the event were evaluated as per TFC in those with a non-specific or normal ECG.
RESULTS: The ECG was non-specific or normal in 17/145 (12%) subjects. Mean age of these patients was 41.3 ± 12.4 years, and 14 (82%) were male, comparable to those with an abnormal ECG. Most patients with a non-specific or normal ECG showed ≥1 TFC on Holter monitoring (n=9/10) and signal-averaged ECG (n=4/5), and all had non-sustained ventricular tachycardia recorded. Among 15 patients who underwent structural evaluation, 11 (73%) showed structural TFC (9 major, 2 minor).
CONCLUSION: Although most ARVD/C patients with arrhythmias have an abnormal ECG, a non-specific or normal ECG does not preclude ARVD/C diagnosis. All patients with a non-specific or normal ECG had alternative evidence of disease expression. These results alert the physician not to exclusively rely on ECG in ARVD/C, but to assess arrhythmic risk by comprehensive clinical evaluation.
Authors:
Anneline S J M Te Riele; Cynthia A James; Aditya Bhonsale; Judith A Groeneweg; Christian F Camm; Brittney Murray; Crystal Tichnell; Jeroen F van der Heijden; Dennis Dooijes; Daniel P Judge; Richard N W Hauer; Harikrishna Tandri; Hugh Calkins
Related Documents :
12063369 - Ventricular pacing or dual-chamber pacing for sinus-node dysfunction.
1582269 - Optimal lead positioning for postoperative atrial pacing.
12400789 - Transesophageal echocardiography guided placement of a coronary sinus pacing lead.
12644009 - Effect of biventricular pacing on heart rate variability in patients with chronic heart...
22199009 - Disparity in left ventricular stimulation among different pacing configurations in card...
17516159 - Transvenous bifocal left ventricular pacing after mechanical prosthetic tricuspid valve...
9924849 - Efficacy and safety of carvedilol in patients with chronic heart failure receiving conc...
9341639 - Unstable angina: integrating new treatments.
12740669 - Doppler echocardiographic evaluation of ventricular function in patients with rheumatoi...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-28
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-7-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier Inc.
Affiliation:
Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Age-Related Variations of Appetite Sensations of Fullness and Satisfaction with Different Dietary En...
Next Document:  Transvenous extraction of implantable cardioverter defibrillator leads under advisory - a comparison...