Arrhythmogenic right ventricular cardiomyopathy: Arrhythmias upstream and downstream

Abstract

By using a large research registry, Camm et al examined the prevalence and characteristics of atrial arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and their relationship to demographics and disease severity. The results are reported in the current issue of the journal. All patients had been genotyped and fulfilled the 2010 Task Force Criteria. Atrial arrhythmia was defined as a narrow complex arrhythmia lasting at least 30 seconds, and it was subclassified into atrial fibrillation, atrial flutter, and other atrial arrhythmias. More than 90% (230 of 248) of the studied patients had an implantable cardioverter-defibrillator (ICD). In brief, 14% (35 of 248) of the studied patients exhibited atrial arrhythmia during follow-up (median 5.8 years). Atrial fibrillation was the most common arrhythmia. Only a third of the arrhythmic episodes were detected by using conventional electrocardiography (ECG; the remainder being detected through ICD interrogation or Holter studies). The authors conclude that atrial arrhythmias are common in patients with ARVC, that atrial arrhythmias occur in younger patients compared to the general population, and that the presence of atrial arrhythmias was associated with atrial enlargement, increasing age and male sex. Atrial arrhythmias have previously been reported with ARVC. The primary contribution of this article is the large number of patients (n = 248) in the registry and the relatively unselected population. The first data indicating that atrial arrhythmia occasionally may be a part of the