Table 3

The 2010 TFC for diagnosis of ARVC

I. Structure/function assessment
Major2D echocardiography:
  • Regional RV akinesia, dyskinesia or aneurysm

  • and 1 of the following at end diastole:.

    • PLAX RVOT ≥32 mm or PLAX/BSA ≥19 mm/m2.

    • PSAX RVOT ≥36 mm or PSAX/BSA ≥21 mm/m2.

    • Fractional area change ≤33%.


CMR:
  • Regional RV akinesia or dyskinesia or dyssynchronous contraction

  • and 1 of the following:

    • RV EDV/BSA ≥110 mL/m2 (male) or ≥100 mL/m2 (female).

    • RVEF ≤40%.


RV angiography:
  • Regional RV akinesia, dyskinesia or aneurysm.

Minor2D echocardiography:
  • Regional RV akinesia, dyskinesia or aneurysm

  • and 1 of the following at end diastole:

    • PLAX RVOT ≥29–<32 mm or PLAX/BSA ≥16–<19 mm/m2.

    • PSAX RVOT ≥32–<36 mm or PSAX/BSA ≥18–<21 mm/m2.

    • Fractional area change >33%–≤40%.


CMR:
  • Regional RV akinesia or dyskinesia or dyssynchronous contraction

  • and 1 of the following (end diastole):

    • RV EDV/BSA ≥100–<110 mL/m2 (male) or ≥90–<100 mL/m2 (female).

    • RVEF >40–≤45%.

II. Tissue characterisation
Major
  • Residual myocytes <60% by morphometric analysis (or <50% if estimated), with fibrous replacement of the RV free wall myocardium in ≥1 sample, with or without fatty replacement of tissue on endomyocardial biopsy.

Minor
  • Residual myocytes 60%–75% by morphometric analysis (or 50%–65% if estimated), with fibrous replacement of the RV free wall myocardium in ≥1 sample, with or without fatty replacement of tissue on endomyocardial biopsy.

III. Repolarisation abnormalities
Major
  • Inverted T-waves in leads V1, V2 and V3 or beyond, in individuals >14 years of age (in absence of complete RBBB QRS ≥120 ms).

Minor
  • Inverted T-waves in leads V1 and V2, in individuals >14 years of age (in absence of complete RBBB) or in V4, V5 or V6.

  • Inverted T-waves in leads V1, V2, V3 and V4 in individuals >14 years of age in the presence of complete RBBB.

IV. Depolarisation abnormalities
Major
  • Epsilon wave (reproducible low-amplitude signals between end of QRS complete to onset of the T-wave) in V1–3.

Minor
  • Late potentials by SAECG in ≥1 of 3 parameters in absence of a QRS of ≥110 ms on standard ECG:

    • Filtered QRS duration ≥114 ms.

    • Duration of terminal QRS <40 µV ≥38 ms.

    • Root-mean-square voltage of terminal 40 ms ≤ 20 µV.

  • Terminal activation duration of QRS ≥55 ms, measured from the nadir of the S-wave to the end of the QRS, including R’, in V1, V2 or V3, in absence of complete RBBB.

V. Arrhythmias
Major
  • Non-sustained or sustained VT of LBBB morphology with superior axis.

Minor
  • Non-sustained or sustained VT of RVOT configuration, LBBB morphology with inferior axis or with unknown axis.

  • >500 PVCs per 24 hours on Holter monitoring.

VI. Family history
Major
  • First-degree relative with ARVC confirmed by TFC.

  • First-degree relative with ARVC confirmed pathologically at autopsy or surgery.

  • Identification of a pathogenic mutation categorised as associated or probably associated with ARVC in the patient under evaluation.

Minor
  • First-degree relative with ARVC history not possible to confirm by TFC.

  • First-degree relative with SCD <35 years of age due to suspected ARVC.

  • Second-degree relative with ARVC confirmed by TFC or pathologically.

  • ARVC, arrhythmogenic right ventricular cardiomyopathy; BSA, body surface area; CMR, cardiac MRI; 2D, two dimensional; EDV, end-diastolic volume; LBBB, left bundle branch block; PLAX, parasternal long-axis; PSAX, paresternal short-axis; PVC, premature ventricular complex; RBBB, right bundle branch block; RV, right ventricular; RVEF, right ventricular ejection fraction; RVOT, RV outflow tract; SAECG, signal-averaged ECG; SCD, sudden cardiac death; TFC, Task Force Criteria; VT, ventricular tachycardia.