Right ventricular tachycardia—arrhythmogenic right ventricular cardiomyopathy or idiopathic?

See doi:10.1016/S1095-668X(02)00654-1for the article to which this editorial refers. The majority of right ventricular tachycardias exhibit a left bundle branch block pattern with an inferior axis. The classical differential diagnosis is either idiopathic right ventricular outflow tract tachycardia or arrhythmogenic right ventricular dysplasia/cardiomyopathy. Recently, the entity of right ventricular outflow tract tachycardia has been extended to outflow tract tachycardias with potential origins in the right ventricular outflow tract, the left ventricular outflow tract or the aortic sinus of valsalva.1,2 Especially the R/S transition in the precordial leads of the 12-lead surface ECG has been useful to differentiate between a left or right-sided origin, with the classical left bundle branch block pattern indicating to the right side and a premature transition at V1 to V3 indicating more towards the left side or the aortic sinus. In some cases, the definite origin may only be defined periinterventionally. In general, right ventricular outflow tract tachycardia occurs in the absence of structural heart disease and has a favorable prognosis.3 In some studies, however, structural abnormalities have been described using magnetic resonance imaging.4 Clinical manifestations include nonsustained or sustained …