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Mechanisms of syncopes in arrhythmogenic right ventricular dysplasia-cardiomyopathy beyond monomorphic ventricular tachycardia.
- Source :
-
International journal of cardiology [Int J Cardiol] 2006 Jan 04; Vol. 106 (1), pp. 52-4. - Publication Year :
- 2006
-
Abstract
- Syncopes appear in 10-20% in arrhythmogenic right ventricular dysplasia-cardiomyopathy (ARVD/C). In the majority of cases sustained or non-sustained monomorphic ventricular tachycardias represent the underlying mechanism of syncope. In other cases the mechanism remains unclear. In 37 patients (23 females, mean age 43.6+/-12.8 years) without detectable and inducible monomorphic ventricular tachycardia, a diagnostic algorithm including repeat ECG, holter monitoring, telemetry, electrophysiological examination, ajmaline challenge, tilt table testing and neurological work-up (EEG, cranial computer tomography) was used in order to identify the mechanism of syncopes. Constant AV block 3 degrees could be found in 3 patients (2 males). Intermittant AV block 2 degrees or 3 degrees could be identified in 3 females. Four males had abnormal Wenckebach point during rapid atrial stimulation, 3 males demonstrate isolated HV interval prolongation. Rapid polymorphic VT and VF could be induced in a young female with ARVD/C. Eight patients (7 females) presented with recurrent syncopes and provocable right precordial ST elevation and right bundle branch block during ajmaline challenge. Three patients had abnormal tilt table testing as the only pathological finding. In one female with intermittent AV block 2 degrees tilt table testing and ajmaline challenge was positive. One female had the diagnosis of focal epilepsia after neurological work-up. In 11 cases the mechanism of syncopes remained unclear. In patients with ARVD/C and syncopes beyond detectable or inducible monomorphic VT, several mechanisms of syncopes could be identified with conduction disease as the predominant finding. These results may help in identifying rare mechanisms of syncopes in ARVD/C.
- Subjects :
- Adolescent
Adult
Aged
Arrhythmogenic Right Ventricular Dysplasia therapy
Cardiomyopathies therapy
Electrophysiologic Techniques, Cardiac
Female
Humans
Male
Monitoring, Physiologic
Pacemaker, Artificial
Recurrence
Syncope therapy
Tachycardia, Ventricular therapy
Arrhythmogenic Right Ventricular Dysplasia physiopathology
Cardiomyopathies physiopathology
Syncope etiology
Syncope physiopathology
Tachycardia, Ventricular physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0167-5273
- Volume :
- 106
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 16321666
- Full Text :
- https://doi.org/10.1016/j.ijcard.2004.12.057