What are the differences between “RVOT” Ventricular tachycardia and ARVD related VT *

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What are the differences between “RVOT” Ventricular tachycardia and ARVD related VT *

November 6, 2012 by dr s venkatesan

A young man with VT (LBBB morphology ) and apparently normal heart by echocardiogram is a real diagnostic challenge .

Here is a comparison of the two closely mimicking entities. RVOT VT and ARVD .

Please note -Micro reentry and triggered activity are very closely related cellular evens. For all clinical reasons there is generally no purpose in differentiating the two.

*Please note -Micro reentry and triggered activity mimic each other at the cellular level . For all clinical reasons there is generally no purpose in differentiating the two.

*RVOT- Right ventricular outflow tract. ARVD/ARVC -Arrhythmogenic right ventricular dysplasia /cardiomyopathy

(Caution : RVOT vs ARVD -In the traditional medical teaching system , we are often taught to differentiate two closely related entities.Our brain also loves to look things in either black or white . Realise , medical science always brings surprises . There can be significant overlaps between the very entities we want to differentiate.Bear that in mind)

Reference

1. Hoffmayer KS, Machado ON, Marcus GM, Electrocardiographic comparison of ventricular arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy and right ventricular outflow tract tachycardia. J Am Coll Cardiol. 2011 Aug 16;58(8):831-8.

2 .Ainsworth CD, Skanes AC, Klein GJ Differentiating arrhythmogenic right ventricular cardiomyopathy from right ventricular outflow tract ventricular tachycardia using multilead QRS duration and axis. Heart Rhythm. 2006 Apr;3(4):416-23.

T wave inversion in V1 TO V3 for diagnosing RVOT VT .

3.Daniel P. Morin, Andreas C. Mauer, Kathleen Gear, Usefulness of Precordial T-Wave Inversion to Distinguish Arrhythmogenic Right Ventricular Cardiomyopathy from Idiopathic Ventricular Tachycardia Arising from the Right Ventricular Outflow Tract .Am J Cardiol. 2010 June 15; 105(12): 1821–1824