Thromboembolic complications in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy.
OBJECTIVE
Incidence and clinical presentation of thromboembolic complications in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) were analysed. In reports on ARVD/C, thromboembolism is rarely mentioned. The possible risk factors are: right ventricle (RV) dilatation, aneurysms, and wall motion abnormalities.


RESULTS
A group of 126 patients (89 male, 37 female, aged 43.6+/-14.3) with ARVD/C was retrospectively analysed for the presence of thromboembolic complications. The mean follow-up period was 99+/-64 months. Thromboembolic complications, i.e. pulmonary embolism (n=2), RV outflow tract thrombosis with severe RV failure (n=1), and cerebrovascular accident associated with atrial fibrillation (n=2) were observed in 4% of the patients. Spontaneous echogenic contrast was observed in seven patients with severe damage to RV. In four of them supraventricular arrhythmias resulting in heart failure were reported. Annual incidence of thromboembolic complications was 0.5/100 patients.


CONCLUSIONS
(i) ARVD/C may be complicated by thrombosis. Annual incidence of such complications is significantly lower than reported for left ventricle failure. (ii) Anticoagulation should be used in ARVD/C patients with large, hypokinetic RV and slow blood flow. (iii) Patients with severe forms of ARVD/C, thrombus formation in the RV and/or spontaneous echocardiographic contrast are at higher risk of a poor outcome.
Wlodarska
Elzbieta Katarzyna
EK
Department of Congenital Heart Diseases, Department of Cardiosurgery, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland. wlodarsk@ikard.waw.pl
Wozniak
Olgierd
O
Konka
Marek
M
Rydlewska-Sadowska
Wanda
W
Biederman
Andrzej
A
Hoffman
Piotr
P
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D004108:Dilatation, Pathologic / Q000473:pathology; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control
D000925:Anticoagulants