ECG and Echocardiography for Identification of Arrhythmic Events in Early ARVC Interview with:
Kristina H. Haugaa, MD, PhD, FESC
Ida Skrinde Leren MD, PhD
Department of Cardiology and
Center for Cardiological Innovation,
Oslo University Hospital, Rikshospitalet
Oslo, Norway What is the background for this study?

Response: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inheritable cardiomyopathy, predisposing to life-threatening arrhythmias. Ventricular arrhythmias are frequent in ARVC patients and importantly, arrhythmias may occur also before evident structural changes are seen, making risk stratification challenging. Additional tools are needed to detect early disease and to optimize medication and timing of implantation of a cardioverter defibrillator (ICD). We aimed to explore early markers of ARVC disease and their association with previous ventricular arrhythmias. What are the main findings?

Response: We found that ARVC subjects with arrhythmic events had increased RV diameters and decreased RV and LV function by echocardiography. Importantly, in patients with early ARVC disease, electrical parameters from signal average ECGs and the two right ventricular (RV) echocardiographic parameters, RV diameter and RV mechanical dispersion, were markers of arrhythmic events. The addition of early structural changes increased the ability to detect subjects with arrhythmic events compared to electrical parameters alone. What should readers take away from your report?

Response: Adding evaluation of 2 easily obtained echocardiographic parameters in risk stratification of early ARVC subjects, increased the ability to detect subjects with a history of arrhythmic events, compared to evaluating only electrical parameters from the Task Force Criteria 2010. We suggest including measurements of RV diameter and RV mechanical dispersion when evaluating arrhythmic risk in ARVC subjects What recommendations do you have for future research as a result of this study?

Response: Further knowledge is needed regarding risk stratification of arrhythmic events in early ARVC. Our study indicates a possible role for evaluating subtle echocardiographic alterations at early stages as part of the evaluation of arrhythmic risk. Prospective studies following asymptomatic early ARVC subjects with repeated echocardiographies should be performed to evaluate potential prognostic markers of arrhythmias. Thank you for your contribution to the community.


Leren IS, Saberniak J, Haland TF, Edvardsen T, Haugaa KH. Combination of ECG and Echocardiography for Identification of Arrhythmic Events in Early ARVC. J Am Coll Cardiol Img. 2016;():. doi:10.1016/j.jcmg.2016.06.011.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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