Article

The prevalence of atrial arrhythmias in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy.

New College, University of Oxford, Oxford, United Kingdom.
Heart rhythm: the official journal of the Heart Rhythm Society (Impact Factor: 4.92). 08/2013; 10(11). DOI: 10.1016/j.hrthm.2013.08.032
Source: PubMed

ABSTRACT Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an inherited cardiomyopathy, characterized by right ventricular dysfunction and ventricular arrhythmias. Limited information is available concerning atrial arrhythmias in ARVD/C.
The purpose of this study was to characterize spontaneous atrial arrhythmias in a large registry population of ARVD/C patients.
Patients (n=248) from the Johns Hopkins ARVD/C registry, meeting the diagnostic criteria and having undertaken genotype analysis, were included. Medical records of each were reviewed to ascertain incidence and characteristics of atrial arrhythmia episodes. Detailed demographic, phenotypic, and structural information were obtained from registry data.
Thirty-five patients with ARVD/C (14%) experienced one or more types of atrial arrhythmia during a median follow-up of 5.78 (IQR=8.52) years. Atrial fibrillation was the most common atrial arrhythmia, occurring in 80% of ARVD/C patients with atrial arrhythmias. Patients developed atrial arrhythmias at a mean age of 43.0±14.0 years. Atrial arrhythmia patients obtained a total of 22 inappropriate ICD shocks during follow-up. Older age at last follow-up (p<0.001) and male gender (p=0.044) were associated with atrial arrhythmia development. Patients with atrial arrhythmias had a higher occurrence of death (p=0.028), heart failure (p<0.001), and left atrial enlargement on echocardiography (p=0.004).
Atrial arrhythmias are common in ARVD/C and present at a younger age than the general population. They are associated with male gender, increasing age, and left atrial enlargement. Atrial arrhythmias are clinically important as they are associated with inappropriate ICD shocks, and increased risk of both death and heart failure.

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Available from: Christian F Camm, Apr 10, 2014
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