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→Diagnose
| Regel 20: | Regel 20: | ||
De European Society of Cardiology heeft een lijst van diagnostische criteria opgesteld waar iemand aan moet voldoen om de diagnose ARVD te stellen. | De European Society of Cardiology heeft een lijst van diagnostische criteria opgesteld waar iemand aan moet voldoen om de diagnose ARVD te stellen. | ||
{| class="wikitable" align="left" width="400px" | |||
{| class="wikitable" align=" | !Major diagnostic criteria for Aritmogenic Right Ventricular Cardiomyopathy<cite>McKenna1994</cite> | ||
! | |- | ||
|<ul><li>Familial disease confirmed at necroscopy or surgery</li> | |||
<li>Severe dilatation and reduciton of right ventricular ejection fraction with no (or only mild) LV impairment</li> | |||
<li>Localised irhgt ventricular aneurysms (akinetic or diskinetic areas with diastolic bulging)</li> | |||
<li>Severe segmental dilataion of the right ventricle</li> | |||
<li>Fibrofatty replacement of myocardium on endomyocardial biopsy</li> | |||
</ul> | |||
|- | |||
!Diagnostic criteria that can be diagnosed on the ECG | |||
|- | |- | ||
|<li> | |<ul> | ||
<li> | <li>(major) Epsilon wave or localised prolongation (>110ms) of the QRS complex in right precordial leads (V1-V3)</li> | ||
<li> | <li>(minor) Inverted T waves in right precordial leads (V2 and V3) (people aged more than 12 yr; in absence of [[RBBB]]</li> | ||
<li> | <li>(minor) Late potentials (signal averaged ECG)</li> | ||
<li> | <li>(minor) Left bundle branch block type [[Ventricular Tachycardia|ventricular tachycardia]] (sutained and non-sustained) (ECG, [[Holter]], [[Exercise Testing|exercise testing]]</li> | ||
<li>(minor) Frequent [[Ventricular Premature Beats|ventricular extrasystoles]] (more than 1000/24h) ([[Holter]])</li> | |||
</ul> | |||
|} | |} | ||
{{clr}} | {{clr}} | ||
'''Treatment''' focuses on avoiding complications.<cite>ACC2006</cite> | |||
*Medication: | |||
**anti-arrithmics: Amiodarone, Sotalol | |||
**ACE-inhibitors to prevent cardiac remodelling | |||
*[[ICD]] implantation is recommended for the prevention of sudden cardiac death in patients with ARVC with documented sustained VT or VF who are receiving chronic optimal medical therapy. | |||
*[[ICD]]] implantation can be considered for the prevention of sudden cardiac death in patients with ARVC with extensive disease, including those with left ventricular involvement, 1 or more affected family member with SCD, or undiagnosed syncope when [[Ventricular Tachycardia|ventricular tachycardia]] or [[Ventricular Fibrillation|ventricular Fibrillation]] has not been excluded as the cause of syncope, who are receiving chronic optimal medical therapy, and who have reasonable expectation of survival with a good functional status for more than 1 y. | |||
*Radiofrequency [[ablation]] can be useful as adjunctive therapy in management of patients with ARVC with recurrent [[Ventricular Tachycardia|ventricular tachycardia]], despite optimal antiarrhythmic drug therapy. | |||
==Referenties== | |||
<biblio> | |||
#McKenna1994 pmid=8142187 | |||
#Corrado pmid=10768917 | |||
#ACC2006 pmid=16949478 | |||
</biblio> | |||
===Behandeling=== | ===Behandeling=== | ||