Yeungnam Univ J Med.  2017 Dec;34(2):208-215. 10.12701/yujm.2017.34.2.208.

Meta-analysis on risk stratification of malignant ventricular tachyarrhythmic events in arrhythmogenic right ventricular cardiomyopathy

• Roh YE
• Jang HJ
• Cho MJ

• KMID: 2400356
• DOI: http://doi.org/10.12701/yujm.2017.34.2.208

Abstract

BACKGROUND
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a cardiomyopathy characterized by predominant right ventricular fibro-fatty replacement, right ventricular dysfunction and ventricular arrhythmias. It is a rare but important cause of sudden cardiac death in children and young adults. A meta-analysis on risk stratification of major ventricular tachyarrhythmic events indicating the need for implantable cardioverter defibrillator therapy in ARVC was performed.
METHODS
The pubmed database was searched from its inception to May 2015. Of the 433 citations identified, 12 were included in this meta-analysis. Data regarding major ventricular tachyarrhythmic events were retrieved in 817 subjects from the studies. For the variables, a combined odds ratio (OR) was calculated using a fixed-effects meta-analysis.
RESULTS
Extensive right ventricular dysfunction (OR, 2.44), ventricular late potential (OR, 1.66), inducible ventricular tachyarrhythmia during electrophysiology study (OR, 3.67), non-sustained ventricular tachycardia (OR, 3.78), and history of fatal event/sustained VT (OR, 5.66) identified as significant risk factors (p < 0.0001).
CONCLUSION
This meta-analysis shows that extensive right ventricular dysfunction, ventricular late potential, inducible ventricular tachyarrhythmia during electrophysiological study, non-sustained ventricular tachycardia, and history of sustained ventricular tachycardia/fibrillation are consistently reported risk factors of major ventricular tachyarrhythmic events indicating implantable cardioverter defibrillator therapy in patients with ARVC.

Keyword

Arrhythmogenic right ventricular cardiomyopathy; Defibrillator; Sudden death; Ventricular tachyarrhythmia; Meta-analysis

MeSH Terms

Arrhythmias, Cardiac
Arrhythmogenic Right Ventricular Dysplasia*
Cardiomyopathies
Child
Death, Sudden
Death, Sudden, Cardiac
Defibrillators
Electrophysiology
Humans
Odds Ratio
Risk Factors
Tachycardia
Tachycardia, Ventricular
Ventricular Dysfunction, Right
Young Adult