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Am J Cardiol. 2019 Feb 23. pii: S0002-9149(19)30237-1. doi: 10.1016/j.amjcard.2019.02.032. [Epub ahead of print]

Bradyarrhythmias in Arrhythmogenic Right Ventricular Cardiomyopathy.

Author information

1
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
2
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China. Electronic address: ianyao@263.net.cn.

Abstract

Less is known about bradyarrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC). This cross-sectional study aimed to assess the prevalence and clinical significance of bradyarrhythmias in ARVC. From May 1995 to December 2017, bradyarrhythmias including sick sinus syndrome, atrioventricular block, and intraventricular conductional block (ICB) were investigated in 522 ARVC patients. A total of 169 patients (32.4%) presented with bradyarrhythmias including sick sinus syndrome in18 (3.5%), atrioventricular block in 56 (10.7%), and ICB in 118 patients (22.6%). Multivariate analysis showed right atrial dilation increased the risk of bradyarrhythmias (odds ratio [OR] 1.641, 95% confidence interval [CI] 1.081 to 2.492, p= 0.020). Bradyarrhythmias were not associated with death and heart transplantation. In patients with bradyarrhythmias, female gender, left atrial diameter >40 mm, and New York Heart Association Ⅲ/Ⅳ increased the risk of death and heart transplantation (hazards ratio [HR] = 2.790, 95% CI 1.220 to 6.377, p = 0.015; HR = 4.913, 95% CI 2.058 to 11.730, p <0.001; HR = 3.223, 95% CI 1.246 to 8.340, p = 0.016). Among the 23 patients who underwent device implantation, left atrial diameter >40mm was associated with death and heart transplantation (HR = 9.523, 95% CI 1.587 to 57.126, p = 0.014). In conclusion, bradyarrhythmias were commonly seen in ARVC, and ICB was the most common type. Female, left atrial diameter >40 mm, and NYHA class were associated with death and heart transplantation.

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