Premature ventricular complexes (PVCs) of left bundle branch block (LBBB) morphology and inferior axis arise from the right ventricular (RV) outflow tract or, less frequently, from the higher portion of the interventricular septum. PVCs of such morphology constitute a manifestation of idiopathic RV tachycardia (IRVT) or an initial arrhythmic manifestation of arrhythmogenic RV cardiomyopathy/ dysplasia (ARVC/D). These 2 diseases initially have similar manifestations but are completely opposite in terms of the prognosis. IRVT is a disease with excellent prognosis, whereas ARVC/D is characterized by a...

Four hundred forty consecutive patients with >1,000 PVCs of LBBB morphology (minor diagnostic criterion of ARVC/D) and no other pre-existing criteria were prospectively enrolled. CMR examination was performed using a 1.5-T Signa CVi scanner (GE, Milwaukee, Wisconsin) with a cardiac phased-array 8-channel coil. For the assessment of regional wall motion (WM) and left ventricular (LV) and RV volumes and mass, cine images were used with a steady-state free precession (Fast Imaging Employing Steady-State Acquisition [FIESTA]) pulse sequence in short-axis views (from atrioventricular valve plane to...

As shown in Table 1, 126 subjects (31.8%) had RV abnormalities (RVA group). Of these, 61 subjects (15.4%) were included in RVA-2 and 65 (16.4%) in the RVA-1 group. The remaining 270 subjects (68.2%) were included in the no-RVA group. Of the 61 patients in the RVA-2 group, 6 patients had WM abnormalities (akinesia/bulging) as major criteria plus 2 minor criteria (mild-to-moderate RV dilation and frequent PVCs), allowing a definite diagnosis of ARVC/D by applying the Task Force Criteria, whereas in the remaining 55, the...

In subjects with frequent PVC of LBBB morphology, CMR allows risk stratification. Patients with frequent PVC of LBBB morphology have been distinguished in 3 different groups according to the presence of RV abnormalities at CMR: at one extreme, IRVT subjects having excellent prognosis, at the other extreme, ARVD/C subjects having worse prognosis, and in the middle grey zone, subjects having few RV abnormalities and intermediate prognosis.

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D'Errico Luigia, Department of Diagnostic and Interventional Radiology. University of Pisa, Italy [email protected] Giovanni Aquaro: Fondazione G.Monasterio CNR-Regione Toscana, Pisa, Italy Alessandro Pingitore. Institute of Clinical Physiology, CNR, Pisa, Italy Elisabetta Strata, Cardiovascular Department, University of Florence, Florence, Italy Gianluca Di Bella, Clinical and Experimental Department of Medicine and Pharmacology, University of Messina, Messina, Italy. Sabrina Molinaro, Fondazione G.Monasterio CNR-Regione Toscana, Pisa, Italy Massimo Lombardi, Fondazione G.Monasterio CNR-Regione Toscana, Pisa, Italy Carlo Bartolozzi, Department of Diagnostic and Interventional Radiology. University of Pisa, Italy