Diagnostic and therapeutic strategies for arrhythmogenic right ventricular dysplasia/cardiomyopathy patient.

Abstract

Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a rare inherited heart muscle disease characterized by ventricular tachyarrhythmia, predominant right ventricular dysfunction, and sudden cardiac death. Its pathophysiology involves close interaction between genetic mutations and exposure to physical activity. Mutations in genes encoding desmosomal protein are the most common genetic basis. Genetic testing plays important roles in diagnosis and screening of family members. Syncope, palpitation, and lightheadedness are the most common symptoms. The 2010 Task Force Criteria is the standard for diagnosis today. Implantation of a defibrillator in high-risk patients is the only therapy that provides adequate protection against sudden death. Selection of patients who are best candidates for defibrillator implantation is challenging. Exercise restriction is critical in affected individuals and at-risk family members. Antiarrhythmic drugs and ventricular tachycardia ablation are valuable but palliative components of the management. This review focuses on the current diagnostic and therapeutic strategies in ARVD/C and outlines the future area of development in this field.

• Authors: Weijia Wang, Cynthia A James, Hugh Calkins
• Journal: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology (Europace) Vol. 21 Issue 1 Pg. 9-21 (Jan 01 2019) ISSN: 1532-2092 [Electronic] England
• PMID: 29688316 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Arrhythmia Agents

Topics

• Anti-Arrhythmia Agents (adverse effects, therapeutic use)
• Arrhythmogenic Right Ventricular Dysplasia (genetics, mortality, physiopathology, therapy)
• Death, Sudden, Cardiac (epidemiology, prevention & control)
• Defibrillators, Implantable
• Electric Countershock (adverse effects, instrumentation, mortality)
• Electrocardiography
• Exercise Tolerance
• Genetic Predisposition to Disease
• Genetic Testing
• Heart Rate
• Humans
• Predictive Value of Tests
• Risk Assessment
• Risk Factors
• Tachycardia, Ventricular (genetics, mortality, physiopathology, therapy)
• Treatment Outcome