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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Serial reevaluation for ARVD/C is indicated in patients presenting with left bundle branch block ventricular

Philippine Kiès1, Marianne Bootsma, Jeroen J Bax

  • 1Leiden University Medical Center, Leiden, The Netherlands.

Journal of Cardiovascular Electrophysiology
|July 14, 2006
PubMed

Insights

Serial reevaluation for arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is crucial for patients with left bundle branch block ventricular tachycardia (LBBB VT). ECG abnormalities may appear before structural changes, necessitating follow-up.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Imaging

Background:

  • Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) diagnosis relies on 1994 International Task Force criteria.
  • Diagnosis requires both electrocardiographic (ECG) and anatomical assessment, challenging in early disease stages.
  • Detecting structural abnormalities can be difficult in mild ARVD/C cases.

Purpose of the Study:

  • To determine which patients with right ventricular tachycardia (VT) require serial reevaluation for ARVD/C.
  • To identify predictors for ARVD/C diagnosis in patients presenting with VT.

Main Methods:

  • Sixty patients with left bundle branch block (LBBB) VT were assessed using the Task Force (TF) criteria.
  • ECG parameters (T-wave inversion, QRS prolongation, epsilon wave) and imaging findings (ventricle dysfunction, dilatation, hypokinesia) were evaluated.
  • Patients were followed for a mean of 47 months, with serial reevaluations performed.

Main Results:

  • Initially, 37% of patients met the TF criteria for ARVD/C.
  • After follow-up, an additional 52% of initially TF-negative patients were diagnosed with ARVD/C.
  • Of the newly diagnosed patients, 92% initially presented with only ECG abnormalities, later developing structural changes.

Conclusions:

  • Electrocardiographic abnormalities can precede structural changes in ARVD/C.
  • Serial reevaluation is indicated for initially TF-negative patients with LBBB VT and isolated ECG abnormalities.
  • Early ECG findings may predict future structural changes in ARVD/C.
Abstract

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