RT-204
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Diagnostic role of magnetic
resonance imaging in subjects with ventricular arrhythmias and suspected arrhythmogenic
right ventricular dysplasia
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Arturo Raisaro*, Silvia Negroni,
Catherine Klersy°, C. Ceriotti, Marina Rovida, Angelo Rossi*, Luigi De Ambroggi.
Division of Cardiology, San Donato Hospital, University of Milan,
*Division of Cardiology and °Biometric Unit, Scientific Direction, IRCCS Policlinico San
Matteo, Pavia, Italy
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Abstract
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Cardiac magnetic resonance imaging (MRI) can be
helpful for detecting the ventricular anatomic and functional abnormalities that might be
related to arrhythmias.
The aim of our study was to assess the role of MRI for the diagnosis of arrhythmogenic
right ventricular dysplasia (ARVD) in patients (pts) with ventricular arrhythmias (VA) and
suspected ARVD.
We studied 63 pts, 24 females and 39 males, aged 14 to 66 years. Pts were divided into
3 groups on the basis of the complexity of VA with left bundle branch block configuration:
Group A, 13 pts with sustained ventricular tachycardia (SVT); Group B, 21 pts with
non-sustained ventricular tachycardia (NSVT); Group C, 29 pts with frequent premature
ventricular complexes (PVC > 1000/24h). The criteria recommended by the Task Force of
the ESC were applied for diagnosing ARVD. The diagnosis was fulfilled when the total score
was > 2 (score 1 was assigned to each major criterion and score 0.5 to each minor
criterion).
Results. Nine pts of Group A (69%), 3 pts of Group B (14%) and 3 pts
of Group C (10%) reached the diagnostic score for ARVD on the basis of
electrocardiographic (VA, typical ECG abnormalities, late potentials) and
echocardiographic (wall motion abnormalities, dilatation of the right ventricle) criteria.
By means of MRI we obtained additional information suitable for the diagnosis in other 3
pts of Group A (23%), 8 pts of Group B (38%) and 8 pts of Group C (28%). In a subset of 13
pts of Group C with no echocardiographic and electrocardiographic abnormalities (except
PVC) MRI was able to reveal typical alteration in only one patient.
In conclusion, MRI enabled to detect ARVD in a greater number of pts compared to
echocardiography (34 vs 15 pts), primarily because it can identify fatty infiltration of
myocardium not revealed by echocardiography. However, in pts presenting only PVC without
other electrocardiographic and echocardiographic abnormalities suggesting ARVD the
indication for MRI remains questionable.
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Key Words
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Arrhythmogenic right ventricular dysplasia
ventricular arrhythmias, left bundle branch block QRS configuration, magnetic resonance
imaging, echocardiography, suden death, young male, exercise, OA
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