An observational study to identify predictors, characteristics, and treatment of ventricular arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy

Abstract

Background: Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is an inherited cardiomyopathy identified by gradual and progressive fibro fatty infiltration of the myocardium which put through patients to ventricular arrhythmias and sudden cardiac
death. However, selection of patients for Implantable Cardioverter-Defibrillator (ICD) is still controversial. Aims: The objective of this study was to identify predictors, characteristics, and treatment of ventricular arrhythmias in patients with ARVC coming to a tertiary care hospital in Eastern India. Methods: A total of 30 patients who visited the hospital fulfilling ARVC Task Force Criteria with corroborative ECG, 2D ECHO, MRI findings, who presented with history of syncope, or episodes of resuscitated cardiac arrest were enrolled in the study.
Results: Of the 30 patients enrolled, 25 (83.333%) received an ICD. Implant complications occurred in 2 patients including an RV perforation and an infection requiring ICD removal and re-implantation. 16 patients had 118 episodes of ventricular arrhythmias, including 105 that were monomorphic and 13 that were polymorphic. In the patients with ICDs, independent predictors of ventricular arrhythmias in follow-up included young age at presentation and T-wave inversions inferiorly. Young age at time of ICD implantation was an independent predictor of life-threatening ventricular arrhythmias.

Conclusions: This study concluded that risk factors for ventricular arrhythmias were spontaneous ventricular arrhythmias before enrollment, an early age of presentation, and T wave inversion on inferior surface of ECG