Arrhythmogenic right ventricular dysplasia: a clinical model for the study of chronic ventricular tachycardia.

摘要: Arrhythmogenic right ventricular dysplasia (ARVD) is a recently individualised clinical entity which sometimes presents with episodes of tachycardia (VT). These attacks may be resistant to anti-arrhythmic therapy and new therapeutic approaches have been developed for the treatment this condition. methods are mainly surgical, based on analysis electrical activation heart in sinus rhythm during VT. This approach has increased our understanding physiopathology VT, not only context ARVD, but also most commonly encountered setting after myocardial infarction. Electrophysiological study epicardial dysplastic zones demonstrated presence delayed potentials recorded end QRS complex. can explained by histopathology these tissues. ARVD characterised histologically partial degeneration wall. Most muscle fibers replaced fatty tissue middle some healthy survive. changes observed intramyocardial subepicardial layers, subendocardium being almost normal. Strands isolated within non-conducting lead very respect adjacent The propagation as it passes through plexiform structure were reentry phenomena arise. In located over ventricle, so explaining origin forms VT However, we case suggested an arrhythmogenic left dysplasia. Epicardial mapping localizes point situated between slow normally conducting Simple ventriculotomy, full thickness section wall, at breakthrough prevents recurrence great majority patients. same pathophysiological concepts applied complicating infarction situation capable slowly fibrous border zone infarct. usually interventricular septum could distance away. Different surgical techniques deal Encircling endocardial ventriculotomy isolates from rest tissues tracin