Abstract 16691: Arrhythmogenic Right Ventricular Cardiomyopathy: comparison between original (1994) and updated (2010) Task Force Criteria.
Introduction: ARVC diagnosis has been based, up to now, on the 1994 international Task Force Criteria (TFC). Due to the high specificity and low sensitivity of this diagnostic approach, a recent international Task Force (2010) has issued updated criteria.
Hypothesis: Evaluate the impact of the updated (2010) TFC for ARVC diagnosis and the relation with adverse long-term clinical events.
Methods: Sixty-three patients (49,7% men) with ARVC diagnosis based on the 1994 TFC were revised with the updated (2010) TFC. Adverse events recorded were: cardiovascular death, aborted sudden cardiac death (ASCD), syncope, sustained ventricular tachycardia (SVT), heart transplant, HF, atrial fibrillation (AF), stroke.
Results: Based on 1994 TFC 17 (27%) patients presented at least 2 major criteria, 37 (59%) 1 major and at least 2 minor criteria, 9 (14%) at least 4 minor criteria. By the 2010 TFC, instead, 46 (73%) patients presented at least 2 major criteria, 11 (17%) 1 major and at least 2 minor criteria, 2 (3%) at least 4 minor criteria. The remaining 4 (6%) failed to reach diagnosis (3 with 1 major and 1 minor criteria, 1 with 3 minor criteria). During 14.6±11.2 years follow-up 5 (8%) patients died for cardiovascular causes (3 for HF and 2 for SCD). ASCD occurred in 5 (8%) patients (1 cardiac arrest with cardiopulmonary resuscitation and 4 appropriate ICD shock on ventricular fibrillation), syncope in 30 (47.6%), SVT in 41 (65%), HF in 16 (25.4%), AF in 15 (23.8%), stroke in 8 (12.7%) and heart transplant in 1 (1.6%). Adverse events during follow-up were homogenously distributed within the three different clusters of diagnosis (2 major criteria vs 1 major and 2 minor vs 4 minor criteria) both by 1994 and 2010 TFC (p=0.498 and p=0.389 respectively). No adverse events occurred within the 4 patients failing to reach ARVC diagnosis based on the 2010 TFC.
Conclusions: This study, not designed to test specificity and sensitivity of ARVC diagnosis by the 2010 TFC, relates cluster of diagnosis to long-term adverse events. The use of 2010 TFC leaded to a 4-patient loss of ARVC diagnosis; none of these patients reported adverse events. Furthermore a larger percentage of patients, by 2010 TFC, were diagnosed as having at least 2 major criteria (73% vs 27%) but this was not related to a worse clinical outcome.
- © 2010 by American Heart Association, Inc.