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Risk Stratification in Arrhythmogenic Right Ventricular Cardiomyopathy.
Hugh Calkins1, Domenico Corrado2, Frank Marcus3
1Cardiology Division, Johns Hopkins Medical Institutions, Baltimore, MD (H.C.).
Circulation
|November 22, 2017
Summary
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart condition. This review focuses on risk stratification to guide implantable cardioverter-defibrillator decisions in ARVC patients.
Area of Science:
- Cardiology
- Genetics
- Pathology
Background:
- Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart disorder.
- It is characterized by ventricular arrhythmias and sudden cardiac death risk.
- Left ventricular involvement and left-dominant forms are recognized, especially in advanced disease.
Purpose of the Study:
- To review literature on risk stratification in ARVC patients.
- To integrate this literature with expert clinical experience.
- To aid in implantable cardioverter-defibrillator (ICD) placement decisions.
Main Methods:
- Literature review on ARVC risk stratification.
- Analysis of clinical parameters influencing sudden cardiac death risk.
- Incorporation of authors' extensive clinical experience.
Main Results:
- Key risk factors for sudden cardiac death in ARVC include electrical instability (arrhythmias, PVCs), proband status, structural disease extent, syncope, male sex, specific mutations (TMEM43), and exercise habits.
- ICD decisions balance life-saving potential against short- and long-term complications.
- Risk assessment considers patient preferences and values.
Conclusions:
- Accurate risk stratification is crucial for managing ARVC patients.
- Informed ICD decisions require comprehensive evaluation of multiple clinical parameters.
- Managing ARVC involves careful consideration of individual patient factors and potential treatment outcomes.
Keywords:
arrhythmogenic right ventricular dysplasiadeath, sudden, cardiacdefibrillators, implantablerisk assessmentsyncopeMore Related Videos
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