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Arrhythmogenic right ventricular cardiomyopathy characterized by recurrent syncope during exercise:A case report

World Journal of Clinical Cases 2021年第16期9卷 4095-4103页

作者： Hao-Yu Wu Yi-Wei Cao Tian-Jiao Gao Jian-Li Fu Lei Liang Department of Cardiology Shaanxi Provincial People’s HospitalXi'an 710068Shaanxi ProvinceChina Department of Electrocardiology Shaanxi Provincial People’s HospitalXi'an 710068Shaanxi ProvinceChina Department of Gastroenterology Xi’an Children’s HospitalXi’an 710003Shaanxi ProvinceChina Department of Ultrasonic Diagnosis Center Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina

BACKGROUND Arrhythmogenic right ventricular(RV)cardiomyopathy is a rare and currently underrecognized cardiomyopathy characterized by the replacement of RV myocardium by fibrofatty *** may be asymptomatic or symptomatic(palpitations or syncope)and may induce sudden cardiac death,especially during *** prevent adverse events such as sudden cardiac death and heart failure,early diagnosis and treatment of arrhythmogenic RV cardiomyopathy(ARVC)are *** report a patient with ARVC characterized by recurrent syncope during exercise who was successfully treated with combined endocardial and epicardial catheter *** SUMMARY A 43-year-old man was referred for an episode of syncope during ***,the patient experienced two episodes of syncope without a firm etiological *** electrocardiogram obtained at admission indicated ventricular tachycardia originating from the inferior wall of the right *** ventricular tachycardia was terminated with intravenous propafenone.A repeat electrocardiogram showed a regular sinus rhythm with negative T waves and a delayed S-wave upstroke from leads V1 to *** magnetic resonance imaging showed RV free wall thinning,regional RV akinesia,RV dilatation and fibrofatty infiltration(RV ejection fraction of 38%).An electrophysiological study showed multiple inducible ventricular tachycardia as of a focal mechanism from the right *** and epicardial voltage mapping demonstrated scar tissue in the anterior wall,free wall and posterior wall of the right *** potentials were also *** patient was diagnosed with ARVC and treated with combined endocardial and epicardial catheter ablation with a very satisfactory follow-up *** Clinicians should be aware of ARVC,and further workup,including imaging with multiple modalities,should be *** combination of epicardial and endocardial catheter ablation can lead to a good outcome.

关键词： Arrhythmogenic right ventricular cardiomyopathy endocardial catheter ablation Epicardial catheter ablation Syncope Exercise Case report

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