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Abstract
Annual Review of Medicine
Vol. 50: 17-35 (Volume publication date February 1999)
(doi:10.1146/annurev.med.50.1.17)
ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA

G. Fontaine, F. Fontaliran, J.L. Hébert, D. Chemla, O. Zenati, Y. Lecarpentier, and R. Frank
Service de Cardiologie, Hôpital Jean Rostand, 39 rue Jean le Galleu, Ivry sur Seine, 94200 France;
Service de Physiologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, Le Kremlin-Bicêtre, 94270
INSERM U451-Loa-Ensta-Ecole Polytechnique Palaiseau, 9112 France

Abstract Arrhythmogenic right ventricular dysplasia (ARVD) is a new form of cardiomyopathy probably more frequent than commonly reported. It is a rare but important cause of sudden arrhythmic death in young, otherwise healthy persons, as well as a subtle cause of congestive heart failure. It may lead to temporary incapacitation with catastrophic consequences. Proper electrocardiographic criteria, echocardiography, nuclear medicine, or magnetic resonance imaging could identify most of these individuals. With the exception of full-thickness histological examination of the right ventricular free wall, contrast ventriculography remains the most definitive standard for a positive diagnosis. The wide clinical spectrum of arrhythmogenic right ventricular cardiomyopathies/dysplasia appears to be the result of one or possibly two factors: (a) replacement of most of the right ventricular myocardium by fat and (b) genetic susceptibility to environmental agents (myocarditis). Current treatment modalities include drug therapy, catheter or surgical ablative techniques, and modern treatments of congestive heart failure. Heart transplant is exceptional. Implantable defibrillators, used alone or in combination with drug therapy, will probably play an increasing role in ARVD and related cardiomyopathies.

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Authors:
G. Fontaine,
F. Fontaliran,
J.L. Hébert,
D. Chemla,
O. Zenati,
Y. Lecarpentier, and
R. Frank
Keywords:
cardiomyopathy
ventricular tachycardia
sudden death

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