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(Circulation. 2001;103:1972.)
© 2001 American Heart Association, Inc.

Clinical Investigation and Reports

Prognostic Value of Radionuclide Angiography in Patients With Right Ventricular Arrhythmias

Dominique Le Guludec, MD, PhD; Hélène Gauthier, MD; Raphael Porcher, PhD; Robert Frank, MD; Doumit Daou, MD; Salah Benelhadj, MD; Antoine Leenhardt, MD; Thomas Lavergne, MD; Marc Faraggi, MD, PhD; Michel S. Slama, MD

From the Service de Médecine Nucléaire, Hôpital Bichat (D.L.G., H.G., D.D., M.F.), Paris, France; Service de Cardiologie, Hôpital A. Béclère (M.S.S.), Clamart, France; Service de Cardiologie, Hôpital J. Rostand (R.F.), Ivry, France; Service de Cardiologie, Hôpital Lariboisière (S.B., A.L.), Paris, France; Service de Cardiologie, Hôpital Broussais (T.L.), Paris, France; and DBIM, Hôpital Saint-Louis (R.P.), INSERM U444, Paris, France.

Correspondence to Dominique Le Guludec, Service de Medecine Nucleaire, Hopital Bichat, 46 rue Henri Huchard, 75018 Paris, France. E-mail dominique.leguludec{at}bch.ap-hop-paris.fr

Background—The prognosis of patients with right ventricular (RV) arrhythmias remains uncertain. This study prospectively evaluated the prognostic value of RV and left ventricular (LV) involvement assessed by radionuclide angiography (RNA) as predictors for sudden death.

Methods and Results—Patients (n=188) with severe arrhythmias originating from the RV were followed up for a mean of 45±34 months. Data on clinical presentation, resting and stress ECG, signal-averaged ECG, 24-hour Holter monitoring, and programmed stimulation were collected along with RNA. Patients were classified as group I (n=82) with normal RNA or group II (n=106) with an abnormal RV suggestive of arrhythmogenic RV cardiomyopathy, classified as diffuse or localized disease, with or without associated LV abnormalities. During follow-up, 14 patients died suddenly, all in group II. None of the clinical and electrical data were predictive of death. An abnormal RNA study was a highly predictive factor for death (P<0.005), as well as the presence of LV abnormalities (P<0.01).

Conclusions—The present study confirms that arrhythmogenic RV cardiomyopathy is a severe disease with a high risk for cardiac death. Evidence of RV abnormalities in patients presenting with RV arrhythmias is highly predictive for sudden death, as is its association with LV involvement.

Key Words: death, sudden • arrhythmia • radioisotopes • cardiomyopathy

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