Clinical course of arrhythmogenic right ventricular cardiomyopathy in the era of implantable cardioverter-defibrillators and radiofrequency catheter ablation.
This study investigated the clinical course of arrhythmogenic right ventricular cardiomyopathy (ARVC) patients and in particular evaluated the contribution of radiofrequency catheter ablation (RFCA) and an implantable cardioverter-defibrillator (ICD) to the treatment of ARVC. ARVC is a myocardial disorder and a cause of sudden cardiac death due to ventricular tachycardia (VT). Little is known about its prognosis in Japanese ARVC patients. Thirty-five ARVC patients were studied. Mean age of patients whose onset of ARVC was congestive heart failure (CHF) (66.0 +/- 4.0 years) was significantly higher than those whose onset was VT (44.5 +/- 14.8 years, P < 0.05). ARVC patients with CHF onset showed significantly higher death rates compared to those with VT onset. ICD treatment significantly reduced episodes of hospitalization due to VT (0.1 +/- 0.4 episodes) in comparison to treatment by RFCA (1.7 +/- 2.2 episodes, P < 0.03). RFCA treatment did not reduce recurrence of VT in the follow-up period. ICD therapy showed comparable mortality to RFCA treatment. The prognosis of ARVC with CHF onset is poor. ICD therapy significantly reduced hospitalization due to VT compared with RFCA treatment. ICD implantation in combination with medication may be a better treatment for ARVC.
Department of Cardiovascular Medicine, Tokyo Medical and Dental University Hospital.
Masatoshi
M
Komura
Jun-Ichi
J
Suzuki
Susumu
S
Adachi
Atsushi
A
Takahashi
Kenichiro
K
Otomo
Junichi
J
Nitta
Mitsuhiro
M
Nishizaki
Tohru
T
Obayashi
Akihiko
A
Nogami
Yasuhiro
Y
Satoh
Kaoru
K
Okishige
Hitoshi
H
Hachiya
Kenzo
K
Hirao
Mitsuaki
M
Isobe
D000293:Adolescent; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D017115:Catheter Ablation; D017147:Defibrillators, Implantable; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
D000889:Anti-Arrhythmia Agents