Document Detail

Mechanisms of syncopes in arrhythmogenic right ventricular dysplasia-cardiomyopathy beyond monomorphic ventricular tachycardia.
MedLine Citation:
PMID:  16321666     Owner:  NLM     Status:  MEDLINE    
Syncopes appear in 10-20% in arrhythmogenic right ventricular dysplasia-cardiomyopathy (ARVD/C). In the majority of cases sustained or non-sustained monomorphic ventricular tachycardias represent the underlying mechanism of syncope. In other cases the mechanism remains unclear. In 37 patients (23 females, mean age 43.6+/-12.8 years) without detectable and inducible monomorphic ventricular tachycardia, a diagnostic algorithm including repeat ECG, holter monitoring, telemetry, electrophysiological examination, ajmaline challenge, tilt table testing and neurological work-up (EEG, cranial computer tomography) was used in order to identify the mechanism of syncopes. Constant AV block 3 degrees could be found in 3 patients (2 males). Intermittant AV block 2 degrees or 3 degrees could be identified in 3 females. Four males had abnormal Wenckebach point during rapid atrial stimulation, 3 males demonstrate isolated HV interval prolongation. Rapid polymorphic VT and VF could be induced in a young female with ARVD/C. Eight patients (7 females) presented with recurrent syncopes and provocable right precordial ST elevation and right bundle branch block during ajmaline challenge. Three patients had abnormal tilt table testing as the only pathological finding. In one female with intermittent AV block 2 degrees tilt table testing and ajmaline challenge was positive. One female had the diagnosis of focal epilepsia after neurological work-up. In 11 cases the mechanism of syncopes remained unclear. In patients with ARVD/C and syncopes beyond detectable or inducible monomorphic VT, several mechanisms of syncopes could be identified with conduction disease as the predominant finding. These results may help in identifying rare mechanisms of syncopes in ARVD/C.
Stefan Peters; Martina Trümmel; Brigitte Koehler; Kai Uwe Westermann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  106     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-02     Completed Date:  2006-03-16     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  52-4     Citation Subset:  IM    
Klinikum Quedlinburg, Internal Medicine-Cardiology, Ditfurter Weg 24, 06484 Quedlinburg, Germany.
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MeSH Terms
Arrhythmogenic Right Ventricular Dysplasia / physiopathology*,  therapy
Cardiomyopathies / physiopathology*,  therapy
Electrophysiologic Techniques, Cardiac
Monitoring, Physiologic
Pacemaker, Artificial
Syncope / etiology*,  physiopathology*,  therapy
Tachycardia, Ventricular / physiopathology*,  therapy

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