cardiovascular disorders
Arrhythmogenic Right Ventricular Cardiomyopathy
Treatment of ARVC
Moderation of physical activity Often an ICD Usually a beta-blocker Sometimes antiarrhythmic drugs (particularlysotaloloramiodarone) Heart failure therapy (including transplantation) as required Treatment of arrhythmogenic right ventricular cardiomyopathy focuses on prevention of sudden death and prevention of symptomatic ventricular tachyarrhythmias. Patients should avoid endurance athletics because such activities foster both disease progression and occurrence of life-threatening arrhythmias. These risks are higher in men and in patients with more advanced disease (as evidenced by more task force criteria). Prevention of sudden death is by an ICD (see also table Indications for Implantable Cardioverter-Defibrillators in Ventricular Tachycardia and Ventricular Fibrillation ). An ICD is recommended for patients with prior sustained VT or resuscitated cardiac arrest or severe right ventricular (or left ventricular) systolic dysfunction. An ICD also may be useful for patients with any major risk factor for sudden death, including prior syncope, non-sustained ventricular tachycardia, or moderate right or left ventricular systolic dysfunction (class IIa indication). A recent Heart Rhythm Society consensus statement also provided recommendations regarding ICD use in patients with ARVC and various combinations of moderate other risk factors ( A beta-blocker (eg,metoprolol) should be used in most patients. Antiarrhythmic therapy with a Class III Antiarrhythmic Drugs , particularly 1.Towbin, JA, McKenna WJ, Abrams DJ, et al: 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy.Heart Rhythm16:e301–e372, 2019. doi: 10.1016/j.hrthm.2019.05.007 