Heart 2001;85:53-56 ( January )

Cardiovascular medicine

Long term results of cardioverter-defibrillator implantation in patients with right ventricular dysplasia and malignant ventricular tachyarrhythmias R Tavernier, S Gevaert, J De Sutter, A De Clercq, H Rottiers, L Jordaens, W Fonteyne

Department of Cardiology, University Hospital Gent, De Pintelaan 185, 9000 Gent, Belgium

Correspondence to: Dr Tavernier rene.tavernier{at}rug.ac.be

Accepted 12 September 2000

OBJECTIVETo study the outcome of patients with arrhythmogenic right ventricular dysplasia treated with an implantable cardioverter-defibrillator (ICD) for ventricular tachyarrhythmias complicated by haemodynamic collapse.
DESIGNObservational study.
SETTINGUniversity hospital.
PATIENTSNine consecutive patients (eight male, one female; mean (SD) age, 36 (18) years) with arrhythmogenic right ventricular dysplasia presenting with ventricular tachycardia and haemodynamic collapse (n = 6) or ventricular fibrillation (n = 3), treated with an ICD.
MAIN OUTCOME MEASURESSurvival; numbers of and reasons for appropriate and inappropriate ICD interventions.
RESULTSAfter a mean (SD) follow up of 32 (24) months, all patients were alive. Six patients received a median of 19 (range 2-306) appropriate ICD interventions for events detected in the ventricular tachycardia window; four received a median of 2 (range 1-19) appropriate ICD interventions for events detected in the ventricular fibrillation window. Inappropriate interventions were seen for sinus tachycardia (18 episodes in three patients), atrial fibrillation (three episodes in one patient), and for non-sustained polymorphic ventricular tachycardia (one episode in one patient).
CONCLUSIONSPatients with arrhythmogenic right ventricular dysplasia and malignant ventricular arrhythmias have a high recurrence rate requiring appropriate ICD interventions, but they also often have inappropriate interventions. Programming the device is difficult because this population develops supraventricular and ventricular tachyarrhythmias with similar rates.


Keywords: arrhythmogenic right ventricular dysplasia; implantable cardioverter defibrillator; arrhythmia

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© 2001 by Heart
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