Electrophysiological study distinguished IRVA from ARVD, with ventricular tachycardia inducibility significantly lower in IRVA (3%) compared to ARVD (93%, p<0.0001).
Observational (n=56)
Can a conventional electrophysiological study differentiate between patients with idiopathic right ventricular arrhythmia (IRVA) and arrhythmogenic right ventricular dysplasia (ARVD)?
Standard electrophysiological studies can reliably differentiate between idiopathic right ventricular arrhythmias and arrhythmogenic right ventricular dysplasia based on VT inducibility, ECG morphology, and fragmented diastolic potentials.
Absolute Event Rate: 3% vs 93%
p-value: p=<0.0001
BACKGROUND: Idiopathic right ventricular arrhythmias (IRVA) are responsive to medical and ablative treatment and have a benign prognosis. Arrhythmias caused by right ventricular dysplasia (ARVD) are refractory to treatment and may cause sudden death. It is difficult to distinguish between these two types of arrhythmia. OBJECTIVE: To differentiate patients with IRVA and ARVD by a conventional electrophysiological study. METHODS: 56 patients with a right ventricular arrhythmia were studied. They had no history or signs of any cardiac disease other than right ventricular dysplasia. They were classified as having IRVA (n = 41) or ARVD (n = 15) on the basis of family history, ECG characteristics, and various imaging techniques. They were further investigated by standard diagnostic electrophysiology. RESULTS: The two groups were clearly distinguished by the electrophysiological study in the following ways: inducibility of ventricular tachycardia by programmed electrical stimulation with ventricular extrastimuli (IRVA 3% v ARVD 93%, p < 0.0001); presence of more than one ECG morphology during tachycardia (IRVA 0% v ARVD 73%, p < 0.0001); and fragmented diastolic potentials during ventricular arrhythmia (IRVA 0% v ARVD 93%, p < 0.0001). Data from the clinical follow up in these patients supported the diagnosis derived from the electrophysiological study. CONCLUSIONS: Patients with IRVA or ARVD can be distinguished by specific electrophysiological criteria. A diagnosis of ARVD can be made reliably on the basis of clinical presentation, imaging techniques, and an electrophysiological study.
Niroomand et al. (Tue,) conducted a observational in Right ventricular arrhythmia (IRVA vs ARVD) (n=56). Electrophysiological study (IRVA group) vs. ARVD group was evaluated on Inducibility of ventricular tachycardia by programmed electrical stimulation with ventricular extrastimuli (p=<0.0001). Electrophysiological study distinguished IRVA from ARVD, with ventricular tachycardia inducibility significantly lower in IRVA (3%) compared to ARVD (93%, p<0.0001).
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