PT  - JOURNAL ARTICLE
AU  - F Niroomand
AU  - C Carbucicchio
AU  - C Tondo
AU  - S Riva
AU  - G Fassini
AU  - A Apostolo
AU  - N Trevisi
AU  - P Della Bella
TI  - Electrophysiological characteristics and outcome in patients with idiopathic right ventricular arrhythmia compared with arrhythmogenic right ventricular dysplasia
AID  - 10.1136/heart.87.1.41
DP  - 2002 Jan 01
TA  - Heart
PG  - 41--47
VI  - 87
IP  - 1
4099  - http://heart.bmj.com/content/87/1/41.short
4100  - http://heart.bmj.com/content/87/1/41.full
SO  - Heart2002 Jan 01; 87
AB  - Background: Idiopathic right ventricular arrhythmias (IRVA) are responsive to medical and ablative treatment and have a benign prognosis. Arrhythmias caused by right ventricular dysplasia (ARVD) are refractory to treatment and may cause sudden death. It is difficult to distinguish between these two types of arrhythmia. Objective: To differentiate patients with IRVA and ARVD by a conventional electrophysiological study. Methods: 56 patients with a right ventricular arrhythmia were studied. They had no history or signs of any cardiac disease other than right ventricular dysplasia. They were classified as having IRVA (n = 41) or ARVD (n = 15) on the basis of family history, ECG characteristics, and various imaging techniques. They were further investigated by standard diagnostic electrophysiology. Results: The two groups were clearly distinguished by the electrophysiological study in the following ways: inducibility of ventricular tachycardia by programmed electrical stimulation with ventricular extrastimuli (IRVA 3% v ARVD 93%, p < 0.0001); presence of more than one ECG morphology during tachycardia (IRVA 0% v ARVD 73%, p < 0.0001); and fragmented diastolic potentials during ventricular arrhythmia (IRVA 0% v ARVD 93%, p < 0.0001). Data from the clinical follow up in these patients supported the diagnosis derived from the electrophysiological study. Conclusions: Patients with IRVA or ARVD can be distinguished by specific electrophysiological criteria. A diagnosis of ARVD can be made reliably on the basis of clinical presentation, imaging techniques, and an electrophysiological study.