Noninvasive Risk Stratification in Arrhythmogenic Right Ventricular Cardiomyopathy
Key result
QRS dispersion, history of syncope, and right and/or left ventricular abnormalities at radionuclide angiography proved to be independent noninvasive predictors of sudden death in ARVC.
Why the study?
What are the independent noninvasive predictors of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy?
Population
Patients with arrhythmogenic right ventricular cardiomyopathy
Design
Review
Authors
Discussion
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Member takes
Implication
These markers may aid ARVC risk stratification; hypothesis-generating, requiring prospective validation before changing practice.
Key Points
- To identify noninvasive clinical and electrocardiographic markers capable of predicting life-threatening ventricular arrhythmias and sudden death in arrhythmogenic right ventricular cardiomyopathy.
- Retrospective synthesis of clinical and pathologic series evaluating risk markers in patients with arrhythmogenic right ventricular cardiomyopathy.
- Assessment of clinical history, resting and signal-averaged electrocardiographic parameters, and radionuclide ventricular imaging for arrhythmic risk.
- Several noninvasive markers associate with adverse risk, including syncope, strenuous exercise, spontaneous ventricular arrhythmias, negative T waves, bundle branch block, and late potentials.
- History of syncope, QRS dispersion, and right or left ventricular abnormalities on radionuclide angiography represent the only confirmed independent noninvasive predictors of sudden death.
Structured PICO
What are the independent noninvasive predictors of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy?
P
Population
Patients with arrhythmogenic right ventricular cardiomyopathy
I
Intervention
Noninvasive risk stratification using clinical markers (e.g., history of syncope, QRS dispersion, radionuclide angiography abnormalities)
O
Outcome
Sudden deathhard clinical
QRS dispersion, history of syncope, and ventricular abnormalities on radionuclide angiography serve as independent noninvasive predictors of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy.
Limitations
- There are no prospective and controlled studies assessing clinical markers that can predict the occurrence of life-threatening ventricular arrhythmias.
- Lack of prospective and controlled studies assessing clinical markers for predicting life-threatening ventricular arrhythmias
Cite This Study
Turrini et al. (2003) conducted a review in Arrhythmogenic Right Ventricular Cardiomyopathy. Noninvasive risk stratification was evaluated on Sudden death. QRS dispersion, history of syncope, and right and/or left ventricular abnormalities at radionuclide angiography proved to be independent noninvasive predictors of sudden death in ARVC.