RVOT vs ARVD/C

Right ventricular outflow tract tachycardia (RVOT) can present similarly to ARVD/C. Refer to the chart below to compare the two.

	RVOT Tachycardia	ARVD/C
Family History of Arrhythmia or Sudden Cardiac Death	No	Frequnently Yes
Arrhythmias	PVBs, nonsustained VT or sustained VT at rest or with exercise	Same
Sudden Cardiac Death	Rare	1% per year
Frontal Plan QRS	Positive in leads III and AVF, negative in lead AVL	Inferior or Superior
T-wave Morphology	T wave upright V2-V5	T wave inverted beyond V1
Parietal Block	QRS duration <110 msec in V1, V2 or V3	QRS duration > 110 msec
T-wave Morphology & Parietal Block		84% sensitivity and 100% specificity
Epsilon Wave V1-V3	Absent	Present 30%
Signal Averaged ECG	Normal	Usually Abnormal
Echocardiogram	Normal	Increased RV size and/or wall motion abnormalities
RV Ventriculogram	Usually Normal	Usually Abnormal
MRI	Usually Normal, but data in literature is conflicting	increased signal intensity of RV free wall; wall motion abnormalities with CINE MRI
Response to Therapy	Acute Vagal Maneouvres Adenosine, Beta-blockers Verapamil Chronic Beta-blockers or verapamil +/- class one antiarrhythmic drugs	Sotalol Amiodrone+/- Beta blockers
RF Ablation	Usually Curative	Seldom Curative; may modify substrate to permit AA drugs effective Arrhythmias or different morphology tend to occur