(Circulation. 1996;94:983-991.)
© 1996 American Heart Association, Inc.
Articles |
Arrhythmogenic Right Ventricular Cardiomyopathy
Dysplasia, Dystrophy, or Myocarditis?
the Departments of Pathology and Cardiology, University of Padua Medical School, Padua, Italy.
Correspondence to Gaetano Thiene, MD, Istituto di Anatomia Patologica, Via A. Gabelli, 61, 35121 Padova, Italy.
Background Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a frequent cause of sudden death in young individuals and athletes. Although familial occurrence has been documented and a gene defect was recently localized on chromosome 14q23-q24 the etiopathogenesis of the disease is still obscure.
Methods and Results A pathological study was conducted in 30 hearts with ARVC (age range, 15 to 65 years; mean, 28 years). In the 27 autopsy cases, the mode of death was sudden in 24 and congestive heart failure in 3. ECG, available in 19 cases, showed inverted T waves in the right precordial leads in 15 cases (79%) and ventricular arrhythmias in 15 (79%). Right ventricular aneurysms were present in 15 hearts (50%) and located in the inferior wall in 12. Left ventricle and ventricular septum were involved in 14 (47%) and 6 (20%) cases, respectively. Scattered foci of lymphocytes with myocardial death were observed in 20 cases (67%). Electron microscopy studies, although confirming the myocardial death and lymphocyte infiltrates, did not show any specific ultrastructural substrate. Two pathological patterns, fatty (40%) and fibrofatty (60%), were identified. The fibrofatty pattern was associated with a thinner right ventricular wall (P<.0001) and a higher occurrence of focal myocarditis (P<.001). In sections of right ventricular free wall with maximal fatty infiltration, the mean percentage area of fatty tissue was 35.9±11.1% in control versus 80.4±9.6% in the ARVC, fatty variety (P<.00001). Involvement of the left ventricle and/or ventricular septum, right ventricular aneurysms, and inflammation were found almost exclusively in the fibrofatty variety.
Conclusions In the fibrofatty variety of ARVC, the myocardial atrophy appears to be the consequence of acquired injury (myocyte death) and repair (fibrofatty replacement), mediated by patchy myocarditis. Whether the inflammation is a primary event or a reaction to spontaneous cell death remains unclear.
Key Words: arrhythmia • cardiomyopathy • death, sudden • myocarditis • pathology
This article has been cited by other articles:
 |
|
 |
|
  D. Corrado, C. Basso, L. Leoni, B. Tokajuk, P. Turrini, B. Bauce, F. Migliore, A. Pavei, G. Tarantini, M. Napodano, et al. Three-Dimensional Electroanatomical Voltage Mapping and Histologic Evaluation of Myocardial Substrate in Right Ventricular Outflow Tract Tachycardia. J. Am. Coll. Cardiol., February 19, 2008; 51(7): 731 - 739. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Sen-Chowdhry, P. Syrris, D. Ward, A. Asimaki, E. Sevdalis, and W. J. McKenna Clinical and Genetic Characterization of Families With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Provides Novel Insights Into Patterns of Disease Expression Circulation, April 3, 2007; 115(13): 1710 - 1720. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A A Tsatsopoulou, N I Protonotarios, and W J McKenna Arrhythmogenic right ventricular dysplasia, a cell adhesion cardiomyopathy: insights into disease pathogenesis from preliminary genotype--phenotype assessment Heart, December 1, 2006; 92(12): 1720 - 1723. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Corrado, C. Basso, A. Pavei, P. Michieli, M. Schiavon, and G. Thiene Trends in Sudden Cardiovascular Death in Young Competitive Athletes After Implementation of a Preparticipation Screening Program JAMA, October 4, 2006; 296(13): 1593 - 1601. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): e247 - e346. [Full Text] [PDF]
|
|
|
|
 |
|
 Writing Committee Members, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 746 - 837. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Basso, E. Czarnowska, M. D. Barbera, B. Bauce, G. Beffagna, E. K. Wlodarska, K. Pilichou, A. Ramondo, A. Lorenzon, O. Wozniek, et al. Ultrastructural evidence of intercalated disc remodelling in arrhythmogenic right ventricular cardiomyopathy: an electron microscopy investigation on endomyocardial biopsies Eur. Heart J., August 1, 2006; 27(15): 1847 - 1854. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. K. Wlodarska, O. Wozniak, M. Konka, W. Rydlewska-Sadowska, A. Biederman, and P. Hoffman Thromboembolic complications in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy Europace, August 1, 2006; 8(8): 596 - 600. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. F. Folino, B. Bauce, G. Frigo, and A. Nava Long-term follow-up of the signal-averaged ECG in arrhythmogenic right ventricular cardiomyopathy: correlation with arrhythmic events and echocardiographic findings Europace, June 1, 2006; 8(6): 423 - 429. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado and G. Thiene Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia: Clinical Impact of Molecular Genetic Studies Circulation, April 4, 2006; 113(13): 1634 - 1637. [Full Text] [PDF]
|
|
|
|
|
|
J.P. van Tintelen, M. M. Entius, Z. A. Bhuiyan, R. Jongbloed, A. C.P. Wiesfeld, A. A.M. Wilde, J. van der Smagt, L. G. Boven, M. M.A.M. Mannens, I. M. van Langen, et al. Plakophilin-2 Mutations Are the Major Determinant of Familial Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Circulation, April 4, 2006; 113(13): 1650 - 1658. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Saleh, O. J. Liakopoulos, and G. D. Buckberg The septal motor of biventricular function Eur. J. Cardiothorac. Surg., April 1, 2006; 29(Suppl_1): S126 - S138. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Pilichou, A. Nava, C. Basso, G. Beffagna, B. Bauce, A. Lorenzon, G. Frigo, A. Vettori, M. Valente, J. Towbin, et al. Mutations in Desmoglein-2 Gene Are Associated With Arrhythmogenic Right Ventricular Cardiomyopathy Circulation, March 7, 2006; 113(9): 1171 - 1179. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Basso, G. Thiene, A. Nava, G. H. Fontaine, P. Fornes, S. Sen-Chowdhry, P. Syrris, W. J. McKenna, M. Norman, J. Mogensen, et al. Letter Regarding Article by Norman et al, "Novel Mutation in Desmoplakin Causes Arrhythmogenic Left Ventricular Cardiomyopathy" * Response Circulation, February 7, 2006; 113(5): e68 - e69. [Full Text] [PDF]
|
|
|
|
|
|
D. Dalal, K. Nasir, C. Bomma, K. Prakasa, H. Tandri, J. Piccini, A. Roguin, C. Tichnell, C. James, S. D. Russell, et al. Arrhythmogenic Right Ventricular Dysplasia: A United States Experience Circulation, December 20, 2005; 112(25): 3823 - 3832. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sen-Chowdhry, P. Syrris, and W. J. McKenna Desmoplakin disease in arrhythmogenic right ventricular cardiomyopathy: early genotype-phenotype studies Eur. Heart J., August 2, 2005; 26(16): 1582 - 1584. [Full Text] [PDF]
|
|
|
|
|
|
B. Bauce, C. Basso, A. Rampazzo, G. Beffagna, L. Daliento, G. Frigo, S. Malacrida, L. Settimo, G. Danieli, G. Thiene, et al. Clinical profile of four families with arrhythmogenic right ventricular cardiomyopathy caused by dominant desmoplakin mutations Eur. Heart J., August 2, 2005; 26(16): 1666 - 1675. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Verma, F. Kilicaslan, R. A. Schweikert, G. Tomassoni, A. Rossillo, N. F. Marrouche, V. Ozduran, O. M. Wazni, S. C. Elayi, L. C. Saenz, et al. Short- and Long-Term Success of Substrate-Based Mapping and Ablation of Ventricular Tachycardia in Arrhythmogenic Right Ventricular Dysplasia Circulation, June 21, 2005; 111(24): 3209 - 3216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado, C. Basso, L. Leoni, B. Tokajuk, B. Bauce, G. Frigo, G. Tarantini, M. Napodano, P. Turrini, A. Ramondo, et al. Three-Dimensional Electroanatomic Voltage Mapping Increases Accuracy of Diagnosing Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia Circulation, June 14, 2005; 111(23): 3042 - 3050. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Yoerger, F. Marcus, D. Sherrill, H. Calkins, J. A. Towbin, W. Zareba, M. H. Picard, and Multidisciplinary Study of Right Ventricular Dyspl Echocardiographic findings in patients meeting task force criteria for arrhythmogenic right ventricular dysplasia: New insights from the multidisciplinary study of right ventricular dysplasia J. Am. Coll. Cardiol., March 15, 2005; 45(6): 860 - 865. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E Hughes and W. J McKenna New insights into the pathology of inherited cardiomyopathy Heart, February 1, 2005; 91(2): 257 - 264. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Beffagna, G. Occhi, A. Nava, L. Vitiello, A. Ditadi, C. Basso, B. Bauce, G. Carraro, G. Thiene, J. A. Towbin, et al. Regulatory mutations in transforming growth factor-{beta}3 gene cause arrhythmogenic right ventricular cardiomyopathy type 1 Cardiovasc Res, February 1, 2005; 65(2): 366 - 373. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Tandri, M. Saranathan, E. R. Rodriguez, C. Martinez, C. Bomma, K. Nasir, B. Rosen, J. A.C. Lima, H. Calkins, and D. A. Bluemke Noninvasive detection of myocardial fibrosis in arrhythmogenic right ventricular cardiomyopathy using delayed-enhancement magnetic resonance imaging J. Am. Coll. Cardiol., January 4, 2005; 45(1): 98 - 103. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Tidholm and L. Jonsson Histologic Characterization of Canine Dilated Cardiomyopathy Vet. Pathol., January 1, 2005; 42(1): 1 - 8. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. E. Marchlinski, E. Zado, S. Dixit, E. Gerstenfeld, D. J. Callans, H. Hsia, D. Lin, H. Nayak, A. Russo, and W. Pulliam Electroanatomic Substrate and Outcome of Catheter Ablative Therapy for Ventricular Tachycardia in Setting of Right Ventricular Cardiomyopathy Circulation, October 19, 2004; 110(16): 2293 - 2298. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Thiene, D. Corrado, and C. Basso Cardiomyopathies: is it time for a molecular classification? Eur. Heart J., October 2, 2004; 25(20): 1772 - 1775. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Castillo, H. Tandri, E. R. Rodriguez, K. Nasir, J. Rutberg, H. Calkins, J. A. C. Lima, and D. A. Bluemke Arrhythmogenic Right Ventricular Dysplasia: Ex Vivo and in Vivo Fat Detection with Black-Blood MR Imaging Radiology, July 1, 2004; 232(1): 38 - 48. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Chimenti, M. Pieroni, A. Maseri, and A. Frustaci Histologic findings in patients with clinical and instrumental diagnosis of sporadic arrhythmogenic right ventricular dysplasia J. Am. Coll. Cardiol., June 16, 2004; 43(12): 2305 - 2313. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Roguin, C. S. Bomma, K. Nasir, H. Tandri, C. Tichnell, C. James, J. Rutberg, J. Crosson, P. J. Spevak, R. D. Berger, et al. Implantable Cardioverter-Defibrillators in patients with arrhythmogenic right ventricular Dysplasia/Cardiomyopathy J. Am. Coll. Cardiol., May 19, 2004; 43(10): 1843 - 1852. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Basso, P. R. Fox, K. M. Meurs, J. A. Towbin, A. W. Spier, F. Calabrese, B. J. Maron, and G. Thiene Arrhythmogenic Right Ventricular Cardiomyopathy Causing Sudden Cardiac Death in Boxer Dogs: A New Animal Model of Human Disease Circulation, March 9, 2004; 109(9): 1180 - 1185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Basso, T. Wichter, G. A Danieli, D. Corrado, E. Czarnowska, G. Fontaine, W. J McKenna, A. Nava, N. Protonotarios, L. Antoniades, et al. Arrhythmogenic right ventricular cardiomyopathy: clinical registry and database, evaluation of therapies, pathology registry, DNA banking Eur. Heart J., March 2, 2004; 25(6): 531 - 534. [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado, L. Leoni, M. S. Link, P. D. Bella, F. Gaita, A. Curnis, J. U. Salerno, D. Igidbashian, A. Raviele, M. Disertori, et al. Implantable Cardioverter-Defibrillator Therapy for Prevention of Sudden Death in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia Circulation, December 23, 2003; 108(25): 3084 - 3091. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado, C. Basso, G. Rizzoli, M. Schiavon, and G. Thiene Does sports activity enhance the risk of sudden death in adolescents and young adults? J. Am. Coll. Cardiol., December 3, 2003; 42(11): 1959 - 1963. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Alcalai, S. Metzger, S. Rosenheck, V. Meiner, and T. Chajek-Shaul A recessive mutation in desmoplakin causes arrhythmogenic right ventricular dysplasia, skin disorder, and woolly hair J. Am. Coll. Cardiol., July 16, 2003; 42(2): 319 - 327. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. O'Donnell, D. Cox, J. Bourke, L. Mitchell, and S. Furniss Clinical and electrophysiological differences between patients with arrhythmogenic right ventricular dysplasia and right ventricular outflow tract tachycardia Eur. Heart J., May 1, 2003; 24(9): 801 - 810. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Kimura, F. Sakai, Y. Sakomura, M. Fujimura, E. Ueno, N. Matsuda, H. Kasanuki, and N. Mitsuhashi Helical CT Features of Arrhythmogenic Right Ventricular Cardiomyopathy RadioGraphics, September 1, 2002; 22(5): 1111 - 1124. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. W. M. Kayser, E. E. van der Wall, M. U. Sivananthan, S. Plein, T. N. Bloomer, and A. de Roos Diagnosis of Arrhythmogenic Right Ventricular Dysplasia: A Review RadioGraphics, May 1, 2002; 22(3): 639 - 648. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Gemayel, A. Pelliccia, and P. D. Thompson Arrhythmogenic right ventricular cardiomyopathy J. Am. Coll. Cardiol., December 1, 2001; 38(7): 1773 - 1781. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Turrini, D. Corrado, C. Basso, A. Nava, B. Bauce, and G. Thiene Dispersion of Ventricular Depolarization-Repolarization : A Noninvasive Marker for Risk Stratification in Arrhythmogenic Right Ventricular Cardiomyopathy Circulation, June 26, 2001; 103(25): 3075 - 3080. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Basso, F. Calabrese, D. Corrado, and G. Thiene Postmortem diagnosis in sudden cardiac death victims: macroscopic, microscopic and molecular findings Cardiovasc Res, May 1, 2001; 50(2): 290 - 300. [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado, C. Basso, and G. Thiene Sudden cardiac death in young people with apparently normal heart Cardiovasc Res, May 1, 2001; 50(2): 399 - 408. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado, C. Basso, G. Buja, A. Nava, L. Rossi, and G. Thiene Right Bundle Branch Block, Right Precordial ST-Segment Elevation, and Sudden Death in Young People Circulation, February 6, 2001; 103(5): 710 - 717. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Nava, B. Bauce, C. Basso, M. Muriago, A. Rampazzo, C. Villanova, L. Daliento, G. Buja, D. Corrado, G. A. Danieli, et al. Clinical profile and long-term follow-up of 37 families with arrhythmogenic right ventricular cardiomyopathy J. Am. Coll. Cardiol., December 1, 2000; 36(7): 2226 - 2233. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. R. Fox, B. J. Maron, C. Basso, S.-K. Liu, and G. Thiene Spontaneously Occurring Arrhythmogenic Right Ventricular Cardiomyopathy in the Domestic Cat : A New Animal Model Similar to the Human Disease Circulation, October 10, 2000; 102(15): 1863 - 1870. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. G. Stevenson and H. T. Aretz Case 20-2000- A 61-Year-Old Man with a Wide-Complex Tachycardia N. Engl. J. Med., June 29, 2000; 342(26): 1979 - 1987. [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado, C. Basso, and G. Thiene CARDIOMYOPATHY: Arrhythmogenic right ventricular cardiomyopathy: diagnosis, prognosis, and treatment Heart, May 1, 2000; 83(5): 588 - 595. [Full Text]
|
|
|
|
 |
|
 F. Calabrese, A. Angelini, G. Thiene, C. Basso, A. Nava, and M. Valente No detection of enteroviral genome in the myocardium of patients with arrhythmogenic right ventricular cardiomyopathy J. Clin. Pathol., May 1, 2000; 53(5): 382 - 387. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado, G. Fontaine, F. I. Marcus, W. J. McKenna, A. Nava, G. Thiene, and T. Wichter Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy : Need for an International Registry Circulation, March 21, 2000; 101 (11): e101 - e106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G. Priori, J. Barhanin, R. N. W. Hauer, W. Haverkamp, H. J. Jongsma, A. G. Kleber, W. J. McKenna, D. M. Roden, Y. Rudy, K. Schwartz, et al. Genetic and Molecular Basis of Cardiac Arrhythmias: Impact on Clinical Management Parts I and II Circulation, February 2, 1999; 99(4): 518 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.G. Priori, J. Barhanin, R.N.W. Hauer, W. Haverkamp, H.J. Jongsma, A.G. Kleber, W.J. McKenna, D.M. Roden, Y. Rudy, K. Schwartz, et al. Genetic and molecular basis of cardiac arrhythmias: Impact on clinical management Eur. Heart J., February 1, 1999; 20(3): 174 - 195. [PDF]
|
|
|
|
|
|
K. Matsuo, T. Nishikimi, C. Yutani, T. Kurita, W. Shimizu, A. Taguchi, K. Suyama, N. Aihara, S. Kamakura, K. Kangawa, et al. Diagnostic Value of Plasma Levels of Brain Natriuretic Peptide in Arrhythmogenic Right Ventricular Dysplasia Circulation, December 1, 1998; 98(22): 2433 - 2440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Ellison, P. Friedman, L. Ganz, and W. Stevenson Entrainment mapping and radiofrequency catheter ablation of ventricular tachycardia in right ventricular dysplasia J. Am. Coll. Cardiol., September 1, 1998; 32(3): 724 - 728. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. Coonar, N. Protonotarios, A. Tsatsopoulou, E. W.A. Needham, R. S. Houlston, S. Cliff, M. I. Otter, V. A. Murday, R. K. Mattu, and W. J. McKenna Gene for Arrhythmogenic Right Ventricular Cardiomyopathy With Diffuse Nonepidermolytic Palmoplantar Keratoderma and Woolly Hair (Naxos Disease) Maps to 17q21 Circulation, May 26, 1998; 97(20): 2049 - 2058. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P. Burke, A. Farb, G. Tashko, and R. Virmani Arrhythmogenic Right Ventricular Cardiomyopathy and Fatty Replacement of the Right Ventricular Myocardium : Are They Different Diseases? Circulation, April 28, 1998; 97(16): 1571 - 1580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Kazmierczak, J De Sutter, R Tavernier, C Cuvelier, C Dimmer, and L Jordaens Electrocardiographic and morphometric features in patients with ventricular tachycardia of right ventricular origin Heart, April 1, 1998; 79(4): 388 - 393. [Abstract] [Full Text]
|
|
|
|
 |
|
 C. Oakley Aetiology, diagnosis, investigation, and management of the cardiomyopathies BMJ, December 6, 1997; 315(7121): 1520 - 1524. [Full Text]
|
|
|
|
|
|
S. Globits, G. Kreiner, H. Frank, G. Heinz, U. Klaar, B. Frey, and H. Gossinger Significance of Morphological Abnormalities Detected by MRI in Patients Undergoing Successful Ablation of Right Ventricular Outflow Tract Tachycardia Circulation, October 21, 1997; 96(8): 2633 - 2640. [ |