Serial Electrocardiographic Evaluation in ARVCD

The ARVC/D is a progressive disorder and ECG testing should be considered as the most useful tool for detecting progression of this disorder. Jaoude et al. [34] performed long-term electrocardiographic follow-up in 36 patients presenting with ARVC/D-re-lated VT and showed that after a maximum of 6 years all patients had developed ECG abnormalities. The authors concluded that long-term electrocardiographic follow-up is necessary to confirm or exclude ARVC/D in patients presenting with a VT originating from the RV. In a study by Kies et al. [35], 60 patients suspected of having ARVC/D were evaluated. Initially, 22 (37%) of these patients were diagnosed as having ARVC/D. After a mean 4-year follow-up, 23 initially ARVC/D-negative patients were re-evaluated because of recurrent symptoms. Of those, 12 (52%) met the ARVC/D Task Force criteria. Eleven of the 12 (92%) patients first presented with ECG abnormalities only, but developed structural abnormalities on imaging at follow-up. The authors concluded that ECG abnormalities may precede structural abnormalities, warranting serial re-evaluation for ARVC/D in initially Task Force criteria-negative patients presenting with LBBB VT with only ECG abnormalities.

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