Clinical Classification of Arrhythmogenic Right Ventricular Cardiomyopathy

Clinical outcomes of implantable cardioverter-defibrillator therapy in noncompaction cardiomyopathy: a systematic review and meta-analysis

A subgroup of patients with noncompaction cardiomyopathy (NCCM) is at increased risk of ventricular arrhythmias and sudden cardiac death (SCD). In selected patients with NCCM, implantable cardioverter-defibrillator (ICD) therapy could be advantageous for preventing SCD. Currently, there is no complete overview of outcome and complications after ICD therapy in patients with NCCM. This study sought to present an overview using pooled data of currently available studies. Embase, MEDLINE, Web of Science, and Cochrane databases were searched and returned 915 studies. After a thorough examination, 12 studies on outcome and complications after ICD therapy in patients with NCCM were included. There were 275 patients (mean age 38.6 years; 47% women) with NCCM and ICD implantation. Most of the patients received an ICD for primary prevention (66%). Pooled analysis demonstrates that the appropriate ICD intervention rate was 11.95 per 100 person-years and the inappropriate ICD intervention rate was 4.8 per 100 person-years. The cardiac mortality rate was 2.37 per 100 person-years. ICD-related complications occurred in 10% of the patients, including lead malfunction and revision (4%), lead displacement (3%), infection (2%), and pneumothorax (2%). Patients with NCCM who are at increased risk of SCD may significantly benefit from ICD therapy, with a high appropriate ICD therapy rate of 11.95 per 100 person-years and a low cardiac mortality rate of 2.37 per 100 person-years. Inappropriate therapy rate of 4.8 per 100 person-years and ICD-related complications were not infrequent and may lead to patient morbidity.

THE KEY-STONES OF RIGHT VENTRICULAR ARRHYTHMOGENIC CARDIOMYOPATHY-INDUCED MORPHOLOGICAL DISARRANGEMENT

Arrhythmogenic right ventricular cardiomyopathy is an urgent problem of modern cardiology. This myocardial remodeling manifests various desmosomopathies, channelopathies, and other mutations resulting in a violation of the coordinated heart work, particularly the myocardium. The incidence of this cardiomyopathy is not significant. Still, it is worth noting that athletes are at an increased risk of developing this disease, emphasizing the importance of studying this topic and its relevance from cardiologists and sports physicians. Moreover, the clinical pattern of this disease is heterogeneous. This pathology requires strengthening control and attention of medical personnel and constant improvement and optimization of diagnostic methods and treatment protocols. In this article, the pathophysiological mechanisms, molecular genetic aspects, and the dynamics of morphofunctional changes are represented in detail. Understanding the mechanisms of etiopathogenesis and the features of morphological changes observed in this cardiomyopathy and its more detailed study is fundamental in developing modern treatment methods to improve patients' quality and life expectancy.

Heart Failure in Patients with Arrhythmogenic Cardiomyopathy

Arrhythmogenic cardiomyopathy (ACM) is a rare inherited cardiomyopathy characterized as fibro-fatty replacement, and a common cause for sudden cardiac death in young athletes. Development of heart failure (HF) has been an under-recognized complication of ACM for a long time. The current clinical management guidelines for HF in ACM progression have nowadays been updated. Thus, a comprehensive review for this great achievement in our understanding of HF in ACM is necessary. In this review, we aim to describe the research progress on epidemiology, clinical characteristics, risk stratification and therapeutics of HF in ACM.