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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 TachycardiaARVD/C
Family History of Arrhythmia or Sudden Cardiac DeathNo
Frequnently Yes
ArrhythmiasPVBs, nonsustained VT or sustained VT at rest or with exerciseSame

Sudden Cardiac Death

Rare

1% per year

Frontal Plan QRS
Positive in leads III and AVF, negative in lead AVLInferior or Superior
T-wave MorphologyT wave upright V2-V5T wave inverted beyond V1
Parietal BlockQRS duration <110 msec in V1, V2 or V3QRS duration > 110 msec
T-wave Morphology & Parietal Block84% sensitivity and 100% specificity
Epsilon Wave V1-V3Absent
Present 30%
Signal Averaged ECGNormal
Usually Abnormal
EchocardiogramNormal
Increased RV size and/or wall motion abnormalities
RV VentriculogramUsually NormalUsually Abnormal
MRIUsually Normal, but data in literature is conflictingincreased signal intensity of RV free wall; wall motion abnormalities with CINE MRI
Response to TherapyAcute
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
 

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