title: Distinguishing Right Ventricular Cardiomyopathy From Idiopathic Right Ventricular Outflow Tract Tachycardia with T-wave Alternans.
abstract: BACKGROUND
  The 2 predominant etiologies of right ventricular tachycardia (VT) are arrhythmogenic right ventricular cardiomyopathy (ARVC) and idiopathic VT arising from the right ventricular outflow tract. Discrimination between these 2 entities is critical, as their prognoses and therapeutic options differ. The microvolt T-wave alternans (TWA) is widely used to predict lethal ventricular arrhythmias in various diseases. However, the clinical significance of TWA in patients with VT originating from the right ventricle has been unknown. This study aims to investigate the possible role of TWA to discriminate ARVC from idiopathic right ventricular outflow tract tachycardia (RVOT-VT).
  
  
  METHODS
  This study enrolled 38 patients (23 male, 43 ± 16 years) with VT originating from the right ventricle. TWA was measured during exercise testing using the modified moving average method. TWA results were compared among patients with ARVC and RVOT-VT.
  
  
  RESULTS
  Twenty-five patients (16 male, 42 ± 16 years) met the Task Force criteria for the diagnosis of ARVC, and 13 patients (7 male, 45 ± 14 years) had idiopathic RVOT-VT. Twenty patients with ARVC had positive TWA test, whereas only 1 patient with RVOT-VT had (80% versus 8%, P < 0.001).
  
  
  CONCLUSIONS
  In patients with VT of right ventricle origin, positive TWA test supports the diagnosis of ARVC.
authors.affiliation: Bayrampasa Kolan Hospital, Cardiology Clinic, Istanbul, Turkey (KY), Cardiology Clinic (SKT), Bursa State Hospital, Bursa, Turkey; Department of Cardiology (EG), School of Medicine, Koc University, Istanbul, Turkey; Department of Cardiology (TA), Kocaeli Derince Research and Education Hospital, Kocaeli, Turkey; and Department of Cardiology (KB, KA), Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Kivanc
authors.initials: K
authors.lastname: Yalin
authors.forename: Ebru
authors.initials: E
authors.lastname: Golcuk
authors.forename: Tolga
authors.initials: T
authors.lastname: Aksu
authors.forename: Selma K
authors.initials: SK
authors.lastname: Tiryakioglu
authors.forename: Ahmet K
authors.initials: AK
authors.lastname: Bilge
authors.forename: Kamil
authors.initials: K
authors.lastname: Adalet
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D014421:Turkey