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Информация Medscape
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a primary disease of heart muscle that results in fibrofatty replacement of the right ventricle and the subepicardial region of the left ventricle. Patients are at high risk for ventricular tachyarrhythmias and sudden death.
Epidemiology
The prevalence of arrhythmogenic right ventricular cardiomyopathy (ARVC) has been estimated at 1:2500 to 1:5000. In series of sudden cardiac death, this condition represents the cause of 2-5% of deaths in young adults, with higher incidences in exertional deaths
Prognosis
Young age, a family history of juvenile sudden death, QRS dispersion greater than or equal to 40 ms, T-wave inversion, left ventricular involvement, ventricular tachycardia, syncope, and previous cardiac arrest are the major risk factors for adverse prognosis.
ECG
According to the revised task force criteria, major ECG criteria include the following:
- Inverted T waves in right precordial leads (V1 -V3) or beyond in individuals older than 14 years in the absence of complete right bundle branch block (RBBB); this feature is seen in 87% of patients with ARVD
- Epsilon waves (low-amplitude signals between end of QRS complex to the onset of T wave) in leads V1 -V3; these are seen in 33% of patients with ARVD
Minor ECG criteria include the following:
- Inverted T waves in leads V1 and V2 in individuals older than 14 years in the absence of complete RBBB or in V4, V5, or V6
- Terminal activation 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 the absence of complete RBBB.
Ventricular ectopics, when present, have a LBBB configuration.