Division of Cardiology, Department of Medicine, Johns Hopkins University, Blalock 545, 600 N. Wolfe St., Baltimore, MD 21287, USA.
Department of Genetics, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, Utrecht, The Netherlands.
Europace. 2023 Nov 2;25(11). doi: 10.1093/europace/euad312.
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heritable cardiomyopathy characterized by a predominantly arrhythmic presentation. It represents the leading cause of sudden cardiac death (SCD) among athletes and poses a significant morbidity threat in the general population. As a causative treatment for ARVC is still not available, the placement of an implantable cardioverter defibrillator represents the current cornerstone for SCD prevention in this setting. Thanks to international ARVC-dedicated efforts, significant steps have been achieved in recent years towards an individualized, patient-centred risk stratification approach. A novel risk calculator algorithm estimating the 5-year risk of arrhythmias of patients with ARVC has been introduced in clinical practice and subsequently validated. The purpose of this article is to summarize the body of evidence that has allowed the development of this tool and to discuss the best way to implement its use in the care of an individual patient.
致心律失常性右室心肌病(ARVC)是一种遗传性心肌病,以心律失常为主要表现。它是运动员心源性猝死(SCD)的主要原因,在普通人群中也存在较高的发病率威胁。由于目前尚无针对 ARVC 的病因治疗方法,因此在这种情况下,植入式心脏复律除颤器的应用是预防 SCD 的基石。近年来,得益于国际上对 ARVC 的专门研究,已经在个体化、以患者为中心的风险分层方法方面取得了重大进展。一种新的风险计算器算法已经在临床实践中引入并验证了用于评估 ARVC 患者 5 年内心律失常风险。本文旨在总结这一工具开发的证据,并讨论如何在个体患者的治疗中最好地应用这一工具。