title: Comparison of patients with early-phase arrhythmogenic right ventricular cardiomyopathy and right ventricular outflow tract ventricular tachycardia.
abstract: OBJECTIVE
  Differentiation between early-phase arrhythmogenic right ventricular cardiomyopathy (ARVC) and right ventricular outflow tract (RVOT)-ventricular tachycardia (VT) can be challenging, and correct diagnosis is important. We compared electrocardiogram (ECG) parameters and morphological right ventricular (RV) abnormalities and investigated if ECG and cardiac imaging can help to discriminate early-phase ARVC from RVOT-VT patients.
  
  
  RESULTS
  We included 44 consecutive RVOT-VT (47 ± 14 years) and 121 ARVC patients (42 ± 17 years). Of the ARVC patients, 77 had definite ARVC and 44 had early-phase ARVC disease. All underwent clinical examination, ECG, and Holter monitoring. Frequency of premature ventricular complexes (PVC) was expressed as percent per total beats/24 h (%PVC), and PVC configuration was recorded. By echocardiography, we assessed indexed RV basal diameter (RVD), indexed RVOT diameter, and RV and left ventricular (LV) function. RV mechanical dispersion (RVMD), reflecting RV contraction heterogeneity, was assessed by speckle-tracking strain echocardiography. RV ejection fraction (RVEF) was assessed by cardiac magnetic resonance imaging (CMR). Patients with early-phase ARVC had lower %PVC by Holter and PVC more frequently originated from the RV lateral free wall (both P < 0.001). RVD was larger (21 ± 3 vs. 19 ± 2 mm, P < 0.01), RVMD was more pronounced (22 ± 15 vs. 15 ± 13 ms, P = 0.03), and RVEF by CMR was decreased (41 ± 8 vs. 49 ± 4%, P < 0.001) in early-phase ARVC vs. RVOT-VT patients.
  
  
  CONCLUSIONS
  Patients with early-phase ARVC had structural abnormalities with lower RVEF, increased RVD, and pronounced RVMD in addition to lower %PVC by Holter compared with RVOT-VT patients. These parameters can help correct diagnosis in patients with unclear phenotypes.
authors.affiliation: Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|University of Oslo, Oslo, Norway.|Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Jørg
authors.initials: J
authors.lastname: Saberniak
authors.affiliation: Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|University of Oslo, Oslo, Norway.
authors.forename: Ida S
authors.initials: IS
authors.lastname: Leren
authors.affiliation: Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|University of Oslo, Oslo, Norway.|Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Trine F
authors.initials: TF
authors.lastname: Haland
authors.affiliation: Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Jan Otto
authors.initials: JO
authors.lastname: Beitnes
authors.affiliation: Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Einar
authors.initials: E
authors.lastname: Hopp
authors.affiliation: Arrhythmia Clinic, Lund University, Skane University Hospital, Lund, Sweden.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Borgquist
authors.affiliation: Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|University of Oslo, Oslo, Norway.|Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
authors.affiliation: Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway kristina.haugaa@rr-research.no.|University of Oslo, Oslo, Norway.|Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Kristina H
authors.initials: KH
authors.lastname: Haugaa
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D006785:Hospitals, University; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway; D016017:Odds Ratio; D011379:Prognosis; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology*; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: ARVC; RVOT-VT; cardiac imaging; ventricular arrhythmias