Back to Search
Start Over
Long-term follow-up and risk assessment of arrhythmogenic right ventricular dysplasia/cardiomyopathy: personal experience from different primary and tertiary centres.
- Source :
-
Journal of cardiovascular medicine (Hagerstown, Md.) [J Cardiovasc Med (Hagerstown)] 2007 Jul; Vol. 8 (7), pp. 521-6. - Publication Year :
- 2007
-
Abstract
- Objectives: Limited data are available on the course of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) because of the low frequency of this diagnosis. A long-term follow-up was analysed in typical ARVD/C patients from different primary and tertiary centres, and risk factors for sudden cardiac death (SCD) and end-stage heart failure were assessed.<br />Methods and Results: A total of 313 patients (197 males) with a mean age of 44.8 +/- 16.5 years were included, with symptoms including aborted SCD (7%), ventricular arrhythmias (47%), additional chest pain (42%), syncopes (17%), and atrial arrhythmias (12%); follow-up duration was 8.5 years. The total annual mortality rate was 0.3%, from SCD in 0.2% and heart failure in 0.1%. In symptomatic or high-risk patients, the annual rate of malignant ventricular arrhythmias was 6 and 9%, respectively. In multivariate analysis, a risk factor for SCD was left ventricular dysfunction. The annual heart failure rate was low at 0.5%; four patients died, two had heart transplants and one tricuspid reconstruction. Intrathoracic cardioverter-defibrillator (ICD) therapy was initiated in 35 patients. Adequate shocks after 6-72 months were delivered in 77%; in the majority aborted sudden death with documented ventricular fibrillation and unstable ventricular tachycardia were underlying arrhythmias.<br />Conclusions: The clinical course of ARVD/C is characterized by a high rate of recurrent malignant ventricular arrhythmias in initially symptomatic and high-risk cases, and is uneventful in primarily asymptomatic affected individuals. The spectrum of clinical symptoms represents a warning symptom initiating the so-called 'hot phase' of the disease in many cases. ICD treatment is highly effective in cases of aborted SCD and unstable ventricular tachycardia.
- Subjects :
- Adolescent
Adrenergic beta-Antagonists therapeutic use
Adult
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Arrhythmogenic Right Ventricular Dysplasia complications
Child
Death, Sudden, Cardiac prevention & control
Defibrillators, Implantable
Diuretics therapeutic use
Electrocardiography
Female
Follow-Up Studies
Germany epidemiology
Heart Failure therapy
Heart Transplantation statistics & numerical data
Humans
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
Risk Assessment
Syncope complications
Tricuspid Valve surgery
Ventricular Dysfunction, Left complications
Arrhythmogenic Right Ventricular Dysplasia mortality
Arrhythmogenic Right Ventricular Dysplasia therapy
Death, Sudden, Cardiac epidemiology
Heart Failure epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1558-2027
- Volume :
- 8
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular medicine (Hagerstown, Md.)
- Publication Type :
- Academic Journal
- Accession number :
- 17568286
- Full Text :
- https://doi.org/10.2459/01.JCM.0000278450.35107.b3