Left ventricular involvement in right ventricular dysplasia

Pinamonti, Bruno; Sinagra, Gianfranco; Salvi, Alessandro; Lenarda, Andrea Di; Morgera, T; Silvestri, Furio; Bussani, Rossana; Camerini, F

doi:10.1016/0002-8703(92)90511-s

Cited by 162 publications

(64 citation statements)

References 28 publications

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“…5,6 T-wave inversion in leads V 1 through V 3 in the absence of RBBB is considered a minor diagnostic criterion for ARVD/C, 5 and its prevalence in ARVD/C has been reported as 55% to 94% in different series. 2,6,9 The extent of right precordial T-wave inversion relates to the degree of RV involvement, as reported by Nava et al 8 Despite the frequent association of T-wave inversion with ARVD/C, it is not specific for ARVD/C, particularly because it may be a normal finding in children less than 12 years of age and can also be seen in normal individuals.…”

Section: Discussionmentioning

confidence: 88%

“…Also, there is a possibility of an overrepresentation of ECG markers currently used as diagnostic criteria, because the same ECG abnormalities were used as criteria for entry into the classification of ARVD/C; however; the prevalence of these features in the present study was similar to that reported in the literature. 2,3,6,9 Third, it is recognized that a prolonged S-wave upstroke directly relates to QRS width in the right precordial leads; nonetheless, it was superior to localized QRS prolongation in distinguishing the mild form of ARVD/C from RVOT and was also an independent ECG marker for predicting VT induction. Finally, the prolonged S-wave upstroke parameter, which we describe for the first time in the present study, has not been validated prospectively.…”

Section: Nasir Et Al Ecg In Arvd/cmentioning

confidence: 99%

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Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity

et al. 2004

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Background-The purpose of this study was to systematically study diagnostic and prognostic electrocardiographic (ECG) characteristics of arrhythmogenic right ventricle dysplasia/cardiomyopathy (ARVD/C). Methods and Results-The patient population included 50 patients with ARVD/C (27 males, 23 females; mean age 38Ϯ15 years). We also analyzed the ECG of 50 age-and gender-matched normal control subject and 28 consecutive patients who presented with right ventricular outflow tract (RVOT) tachycardia. Right bundle-branch block (RBBB) was present in 11 patients (22%). T-wave inversions in V 1 through V 3 were observed in 85% of ARVD/C patients in the absence of RBBB compared with none in RVOT and normal controls, respectively (PϽ0.0001); epsilon waves were seen in 33%, and a QRS duration Ն110 ms in V 1 through V 3 was present in 64% of patients. Among those without RBBB, our newly proposed criterion of "prolonged S-wave upstroke in V 1 through V 3" Ն55 ms was the most prevalent ECG feature (95%) and correlated with disease severity and induction of VT on electrophysiological study. This feature also best distinguished ARVD/C (diffuse and localized) from RVOT. Conclusions-A prolonged S-wave upstroke in V 1 through V 3 is the most frequent ECG finding in ARVD/C and should be considered as a diagnostic ECG marker.

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Section: Discussionmentioning

confidence: 88%

Section: Nasir Et Al Ecg In Arvd/cmentioning

confidence: 99%

Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity

et al. 2004

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“…Fax: 56-32-2658527 diaz.rienzi@gmail.com L a displasia arritmogénica del ventrículo derecho (DAVD) es una miocardiopatía hereditaria y progresiva que compromete principalmente el ventrículo derecho (VD) [1][2][3] , pero también puede afectar el ventrículo izquierdo (VI) aumentando su severidad 1,2,4,5 . Histopatológica-mente se caracteriza por reemplazo fibrograso del tejido miocardio que produce un daño estructural progresivo 4,6 , manifestado comúnmente por taquicardia ventricular (TV) y muerte súbita 4,7 .…”

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Displasia arritmogénica del ventrículo derecho con compromiso de ventrículo izquierdo: valor diagnóstico de la resonancia cardiaca

Díaz

Silva²

2014

Rev. méd. Chile

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“…Left ventricular involvement is associated with clinical arrhythmic events and, compared with cases of isolated right ventricular involvement, is associated with more severe cardiomegaly, inflammatory infiltrates and heart failure. 1,6 Arrhythmogenic right ventricular cardiomyopathy has anatomic, functional and tissue-specific characteristics; thus, cardiovascular magnetic resonance imaging is an ideal technique for diagnosis. 4 It allows evaluation of regional wall-motion abnormalities, increased right ventricular volumes, local aneurysms, increased signal intensity suggestive of fatty infiltration and hyperenhancement of fibrous areas after injection of a contrast agent.…”

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confidence: 99%

Arrhythmogenic right ventricular cardiomyopathy with evidence of biventricular involvement

Nijveldt

Beek²,

Germans³

et al. 2007

Canadian Medical Association Journal

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The case: A 37-year-old man was admitted to our hospital with recurrent palpitations. Arrhythmogenic right ventricular cardiomyopathy had been diagnosed 10 years before admission and had been treated with sotalol. Physical examination revealed a blood pressure of 160/98 mm Hg and a heart rate of 150 beats/min, but no other abnormalities. An electrocardiogram showed ventricular tachycardia ( Fig. 1) that, after an intravenous infusion of procainamide, converted to sinus rhythm with epsilon waves and T-wave inversions in the precordial leads (Fig. 2). An echocardiogram showed that the right side of the heart was dilated in the absence of intracardiac shunts and that there was impaired left ventricular function with regional wall-motion abnormalities. Cardiac catheterization, performed to exclude coronary artery disease, showed normal coronary arteries. The patient was referred for cardiac magnetic resonance imaging.Spin echo images showed a thinned right ventricular free wall and focal hyperintensity suggestive of fatty infiltration at the level of the apex and right ventricular free wall (Fig. 3). Typical focal dyskinetic bulging in the free wall of the right ventricle was seen on cine imaging (Fig. 4, D and E). The left ventricle also showed regional wall thinning with wall-motion abnormalities in the inferoposterolateral region and moderate impairment of global left ventricular function (Fig. 4, A and B). Late gadolinium-enhanced images showed various areas of hyperenhancement in the inferoposterolateral region, septum and right ventricular free wall (Fig. 4, C and F). See videos online at www.cmaj.ca/cgi/content/full /176/13/1819/DC1.The combination of ventricular tachycardia of right ventricular origin, epsilon waves on the electrocardiogram, right ventricular aneurysms and the findings of cardiovascular magnetic resonance imaging in the left ventricle in the absence of coronary artery disease were diagnostic of arrhythmogenic right ventricular cardiomyopathy with biventricular involvement. The patient had symptoms of ventricular arrhythmia despite adequate sotalol therapy; thus, catheter ablation was considered but was unsuccessful because of multiple foci. Despite a lack of evidence in the literature, the patient was given amiodarone therapy. He showed a favourable response and was still free of symptoms on follow-up 3 years later.Arrhythmogenic right ventricular cardiomyopathy is a disease of the right ventricle of the heart with a genetic basis. It is characterized by myocardial atrophy and fibrofatty replacement, and ventricular arrhythmias. dominant trait with incomplete penetrance, although recessive forms have been described. 4 The prevalence in the general population is about 1 in 5000, and it is an important cause of sudden cardiac death in young adults. 5,6 This pathological diagnosis is difficult to establish in clinical practice; thus, an expert consensus group has proposed criteria to allow confirmation of the diagnosis (Box 1).3 Genetic analysis, although in its infancy for this disease, may b...

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Left ventricular involvement in right ventricular dysplasia

Cited by 162 publications

References 28 publications

Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity

Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity

Displasia arritmogénica del ventrículo derecho con compromiso de ventrículo izquierdo: valor diagnóstico de la resonancia cardiaca

Arrhythmogenic right ventricular cardiomyopathy with evidence of biventricular involvement

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