[Complementary value of the isoprenaline test and high-amplification ECG in the diagnosis of arrhythmogenic dysplasia of the right ventricle].
Arrhythmogenic dysplasia of the right ventricle is a common cause of ventricular arrhythmia. It is important to reach a diagnosis, due to the risk of sudden death, particularly as this may be the first sign of the disease. Diagnosis is based on the angiographic demonstration of a morphological or structural abnormality of the right ventricle, and non-invasive tests are relatively insensitive. From a case investigated in 1984, the authors carried out a prospective determination of the diagnostic value of the isoprenaline test in 61 patients suffering from arrhythmogenic dysplasia of the right dysplasia confirmed by angiography. High concentrations (8-30 micrograms/min) of isoprenaline were continuously infused over a period of 3 minutes, regardless of the heart rate achieved. In a control group of 50 subjects with no myocardial disorder, isoprenaline induced monomorphic wave-burst arrhythmia in only one patient (2%). In the subjects affected by right ventricular arrhythmogenic dysplasia, isoprenaline induced one or more episodes of wave-burst ventricular arrhythmia in 52 patients (85%): one triplet in four patients, several episodes of wave-burst arrhythmia in 31 patients and prolonged ventricular tachycardia in 17 patients. Polymorphic arrhythmia occurred in 80% of cases, but left lag forms predominated. High-amplification ECG demonstrated late potentials in 66% of cases, i.e. in 80 and 62% of patients with and without prolonged VT respectively. The isoprenaline test or high-amplification ECG gave abnormal results in 58 of the 61 patients, with a cumulative sensitivity of 95 percent.
Haissaguerre
M
M
Service de Cardiologie, Hôpital Saint-André, Bordeaux, France.
Chavernac
P
P
Le Métayer
P
P
Barat
J L
JL
Montserrat
P
P
Héraudeau
A
A
Warin
J F
JF
D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D007545:Isoproterenol; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017180:Tachycardia, Ventricular / Q000139:chemically induced
D007545:Isoproterenol
Valeur complémentaire du test à l'isoprénaline et de l'ECG à haute amplification dans le diagnostic de la dysplasie arythmogène du ventricule droit.