title: Rare case of left-dominant arrhythmogenic right ventricular cardiomyopathy with dramatic reverse remodeling after cardiac resynchronization as an adjunct to pharmacological therapy.
abstract: A 57-year-old man presented with near syncope and hemodynamic compromise after exercise. A sustained ventricular tachycardia (VT) of right bundle-branch block morphology was evident upon examination at our emergency department. Baseline 12-lead electrocardiography revealed a sinus rhythm with a complete left bundle-branch block after successful cardioversion of the VT. Coronary angiography revealed patent coronary arteries, whereas left ventriculography demonstrated impaired systolic function, accompanied by a peculiar basal lateral aneurysm. Both echocardiography and magnetic resonance imaging were consistent with a diagnosis of left-dominant arrhythmogenic right ventricular cardiomyopathy. Four months later, substantial ventricular reverse remodeling and clinical improvements were observed after cardiac resynchronization therapy with a defibrillator, as an adjunct to conventional pharmacological therapy.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chih-Chung
authors.initials: CC
authors.lastname: Hsiao
authors.forename: Jen-Yuan
authors.initials: JY
authors.lastname: Kuo
authors.forename: Chun-Ho
authors.initials: CH
authors.lastname: Yun
authors.forename: Chung-Lieh
authors.initials: CL
authors.lastname: Hung
authors.forename: Cheng-Ho
authors.initials: CH
authors.lastname: Tsai
authors.forename: Hung-I
authors.initials: HI
authors.lastname: Yeh
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D020257:Ventricular Remodeling
chemical_list: D000889:Anti-Arrhythmia Agents