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Arrhythmogenic Right Ventricular Cardiomyopathy: Difference between revisions
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Arrhythmogenic Right Ventricular Cardiomyopathy (view source)
Revision as of 23:42, 25 November 2011
, 25 November 2011→Revised Task Force Criteria ARVD / ARVC
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{| class="wikitable" style="width:700px" | {| class="wikitable" style="width:700px" | ||
|+ Comparison of Original and Revised Task Force Criteria | |+ Comparison of Original and Revised Task Force Criteria | ||
! | ! colspan="2" style="width:600px" | Revised Task Force Criteria | ||
|- | |- | ||
| colspan="2" | '''I. Global or regional dysfunction and structural alterations<sup>∗</sup>''' | | colspan="2" | '''I. Global or regional dysfunction and structural alterations<sup>∗</sup>''' | ||
|- | |- | ||
| | | style="width:300px" | '''Major''' | ||
| style="width:300px" |'"Minor'" | |||
|- | |- | ||
| valign="top" style="padding-left:24px" | | | valign="top" style="padding-left:24px" | | ||
<strong>By 2D echo:</strong> | <strong>By 2D echo:</strong> | ||
* Regional RV akinesia, dyskinesia, or aneurysm | * Regional RV akinesia, dyskinesia, or aneurysm | ||
| Line 87: | Line 83: | ||
<strong>By RV angiography:</strong> | <strong>By RV angiography:</strong> | ||
* Regional RV akinesia, dyskinesia, or aneurysm | * Regional RV akinesia, dyskinesia, or aneurysm | ||
| valign="top" | | |||
| valign="top" | | |||
<strong>By 2D echo:</strong> | <strong>By 2D echo:</strong> | ||
* Regional RV akinesia or dyskinesia | * Regional RV akinesia or dyskinesia | ||
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| colspan="2" | '''II. Tissue characterization of wall''' | | colspan="2" | '''II. Tissue characterization of wall''' | ||
|- | |- | ||
| | | '''Major''' | ||
| '''Minor''' | |||
|- | |- | ||
| valign="top" | | valign="top" | | ||
| | |||
* Residual myocytes <60% by morphometric analysis (or <50% if estimated), with fibrous replacement of the RV free wall myocardium in ≥1 sample, with or without fatty replacement of tissue on endomyocardial biopsy | * Residual myocytes <60% by morphometric analysis (or <50% if estimated), with fibrous replacement of the RV free wall myocardium in ≥1 sample, with or without fatty replacement of tissue on endomyocardial biopsy | ||
| valign="top" | | |||
| valign="top" | | |||
* Residual myocytes 60% to 75% by morphometric analysis (or 50% to 65% if estimated), with fibrous replacement of the RV free wall myocardium in ≥1 sample, with or without fatty replacement of tissue on endomyocardial biopsy | * Residual myocytes 60% to 75% by morphometric analysis (or 50% to 65% if estimated), with fibrous replacement of the RV free wall myocardium in ≥1 sample, with or without fatty replacement of tissue on endomyocardial biopsy | ||
|- | |- | ||
| colspan="2" | '''III. Repolarization abnormalities''' | | colspan="2" | '''III. Repolarization abnormalities''' | ||
|- | |- | ||
|''' | | '''Major''' | ||
| '''Minor''' | |||
|- | |- | ||
| | | valign="top" | | ||
| | |||
* Inverted T waves in right precordial leads (V<sub>1</sub>, V<sub>2</sub>, and V<sub>3</sub>) or beyond in individuals >14 years of age (in the absence of complete right bundle-branch block QRS ≥120 ms) | * Inverted T waves in right precordial leads (V<sub>1</sub>, V<sub>2</sub>, and V<sub>3</sub>) or beyond in individuals >14 years of age (in the absence of complete right bundle-branch block QRS ≥120 ms) | ||
| valign="top" | | |||
| valign="top" | |||
| | |||
* Inverted T waves in leads V<sub>1</sub> and V<sub>2</sub> in individuals >14 years of age (in the absence of complete right bundle-branch block) or in V<sub>4</sub>, V<sub>5</sub>, or V<sub>6</sub> | * Inverted T waves in leads V<sub>1</sub> and V<sub>2</sub> in individuals >14 years of age (in the absence of complete right bundle-branch block) or in V<sub>4</sub>, V<sub>5</sub>, or V<sub>6</sub> | ||
* Inverted T waves in leads V<sub>1</sub>, V<sub>2</sub>, V<sub>3</sub>, and V<sub>4</sub> in individuals >14 years of age in the presence of complete right bundle-branch block | * Inverted T waves in leads V<sub>1</sub>, V<sub>2</sub>, V<sub>3</sub>, and V<sub>4</sub> in individuals >14 years of age in the presence of complete right bundle-branch block | ||
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| colspan="2" | '''IV. Depolarization/conduction abnormalities''' | | colspan="2" | '''IV. Depolarization/conduction abnormalities''' | ||
|- | |- | ||
| | | '''Major''' | ||
| '''Minor''' | |||
|- | |- | ||
| | | valign="top" | | ||
| | |||
* Epsilon wave (reproducible low-amplitude signals between end of QRS complex to onset of the T wave) in the right precordial leads (V<sub>1</sub> to V<sub>3</sub>) | * Epsilon wave (reproducible low-amplitude signals between end of QRS complex to onset of the T wave) in the right precordial leads (V<sub>1</sub> to V<sub>3</sub>) | ||
| | | valign="top | | ||
| | |||
* Late potentials by SAECG in ≥1 of 3 parameters in the absence of a QRS duration of ≥110 ms on the standard ECG | * Late potentials by SAECG in ≥1 of 3 parameters in the absence of a QRS duration of ≥110 ms on the standard ECG | ||
* Filtered QRS duration (fQRS) ≥114 ms | * Filtered QRS duration (fQRS) ≥114 ms | ||
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| colspan="2" | '''V. Arrhythmias''' | | colspan="2" | '''V. Arrhythmias''' | ||
|- | |- | ||
| | | '''Major''' | ||
| '''Minor''' | |||
|- | |- | ||
| | | valign="top" | | ||
| | |||
* Nonsustained or sustained ventricular tachycardia of left bundle-branch morphology with superior axis (negative or indeterminate QRS in leads II, III, and aVF and positive in lead aVL) | * Nonsustained or sustained ventricular tachycardia of left bundle-branch morphology with superior axis (negative or indeterminate QRS in leads II, III, and aVF and positive in lead aVL) | ||
| | | valign="top | | ||
| | |||
* Nonsustained or sustained ventricular tachycardia of RV outflow configuration, left bundle-branch block morphology with inferior axis (positive QRS in leads II, III, and aVF and negative in lead aVL) or of unknown axis | * Nonsustained or sustained ventricular tachycardia of RV outflow configuration, left bundle-branch block morphology with inferior axis (positive QRS in leads II, III, and aVF and negative in lead aVL) or of unknown axis | ||
* >500 ventricular extrasystoles per 24 hours (Holter) | * >500 ventricular extrasystoles per 24 hours (Holter) | ||
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| colspan="2" | '''VI. Family history''' | | colspan="2" | '''VI. Family history''' | ||
|- | |- | ||
| | | '''Major''' | ||
| '''Minor''' | |||
|- | |- | ||
| | | valign="top" | | ||
| | |||
* ARVC/D confirmed in a first-degree relative who meets current Task Force criteria | * ARVC/D confirmed in a first-degree relative who meets current Task Force criteria | ||
* ARVC/D confirmed pathologically at autopsy or surgery in a first-degree relative | * ARVC/D confirmed pathologically at autopsy or surgery in a first-degree relative | ||
* Identification of a pathogenic mutation<sup>†</sup> categorized as associated or probably associated with ARVC/D in the patient under evaluation | * Identification of a pathogenic mutation<sup>†</sup> categorized as associated or probably associated with ARVC/D in the patient under evaluation | ||
| | | valign="top | | ||
| | |||
* History of ARVC/D in a first-degree relative in whom it is not possible or practical to determine whether the family member meets current Task Force criteria | * History of ARVC/D in a first-degree relative in whom it is not possible or practical to determine whether the family member meets current Task Force criteria | ||
* Premature sudden death (<35 years of age) due to suspected ARVC/D in a first-degree relative | * Premature sudden death (<35 years of age) due to suspected ARVC/D in a first-degree relative | ||