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  • Erica S. Zado
    Correspondence
    Address reprint requests and correspondence: Ms Erica S. Zado, Section of Cardiac Electrophysiology, Cardiovascular Division, Hospital of the University of Pennsylvania, Founders 9, 3400 Spruce St, Philadelphia, PA 19104.
    Affiliations
    Section of Cardiac Electrophysiology, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Published:November 10, 2022DOI:https://doi.org/10.1016/j.hrthm.2022.11.005
      In this observational retrospective cohort study, Gasperetti et al (Circulation 2022;146:1434, PMID 36205131) sought to assess whether programmed ventricular stimulation (PVS) performed in patients with definite arrhythmogenic right ventricular cardiomyopathy (ARVC) provides additional prognostic information beyond risk stratification obtained from noninvasive studies. Study subjects came from ARVC registries from 12 centers in 7 countries. All patients had definite ARVC on the basis of 2010 Task Force criteria and had electrocardiographic (ECG), monitoring, cardiac magnetic resonance imaging (cMRI), and echocardiographic data available to enter variables into a previously established and validated risk calculator (https://www.ARVCrisk.com). The variables needed for this calculator are age, gender, history of syncope, number of ECG leads with T-wave inversion (TWI), 24-hour premature ventricular contraction (PVC) count, nonsustained ventricular tachycardia (NSVT), and right ventricular ejection fraction (RVEF). None of the patients had a history of sustained VT (SuVT) or aborted sudden cardiac death (SCD). All patients underwent PVS within 1 year of ARVC diagnosis. PVS was considered positive (PVS+) if sustained monomorphic VT was induced. Induction of polymorphic VT or ventricular fibrillation (VF) was not considered a positive PVS result. The primary outcome was sustained ventricular arrhythmia (VA) defined as SCD, SuVT, VF, or appropriate implantable cardioverter-defibrillator (ICD) therapy occurring within 5 years of ARVC diagnosis.
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