Risk factors of cardiac arrest in arrhythmogenic right ventricular dysplasia

Abstract

Arrhythmogenic right ventricular dysplasia is an important cause of ventricular arrhythmia with a potential risk of sudden cardiac death in a young population. In order to define risk factors of cardiac arrest, angiographic and electrophysiological data from 60 patients with angiographically documented arrhythmogenic right ventricular dysplasia (of whom 20 also had spontaneous non-sustained ventricular arrhythmias, 27 sustained ventricular tachycardia and 13 suffered cardiac arrest with documented ventricular fibrillation before resuscitation) were analysed. There were no statistically significant differences in right ventricular volume, global right ventricular ejection fraction (RVEF), right ventricular structure, mean age at the time of diagnosis and angiographic left ventricular contraction abnormalities in the subgroups of patients with different forms of spontaneous arrhythmias. Only in a subgroup of patients with cardiac arrest and inducible sustained ventricular tachycardia did right ventricular volume (P < 0.05), ejection fraction (P < 0.001) and the amount of structural changes (P < 0.01) reveal significant results. A subgroup of patients with structural alterations and a low level of right ventricular function is at a high risk of cardiac arrest, although strenuous exercise and sport remain most important risk factors.