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Europace Advance Access published online on June 7, 2006
Europace, doi:10.1093/europace/eul053
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© The European Society of Cardiology 2006. All rights reserved
Received October 20, 2005
Accepted March 9, 2006

Article

Thromboembolic complications in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy

Elzbieta Katarzyna Wlodarska 1 *, Olgierd Wozniak 1, Marek Konka 1, Wanda Rydlewska-Sadowska 1, Andrzej Biederman 1, and Piotr Hoffman 1

1 Department of Congenital Heart Diseases, Department of Cardiosurgery, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland

* To whom correspondence should be addressed.
Elzbieta Katarzyna Wlodarska, E-mail: wlodarsk{at}ikard.waw.pl


  Abstract

Aims Incidence and clinical presentation of thromboembolic complications in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) were analysed. In reports on ARVD/C, thromboembolism is rarely mentioned. The possible risk factors are: right ventricle (RV) dilatation, aneurysms, and wall motion abnormalities.

Methods and results A group of 126 patients (89 male, 37 female, aged 43.6 ± 14.3) with ARVD/C was retrospectively analysed for the presence of thromboembolic complications. The mean follow-up period was 99 ± 64 months. Thromboembolic complications, i.e. pulmonary embolism (n=2), RV outflow tract thrombosis with severe RV failure (n=1), and cerebrovascular accident associated with atrial fibrillation (n=2) were observed in 4% of the patients. Spontaneous echogenic contrast was observed in seven patients with severe damage to RV. In four of them supraventricular arrhythmias resulting in heart failure were reported. Annual incidence of thromboembolic complications was 0.5/100 patients.

Conclusions (i) ARVD/C may be complicated by thrombosis. Annual incidence of such complications is significantly lower than reported for left ventricle failure. (ii) Anticoagulation should be used in ARVD/C patients with large, hypokinetic RV and slow blood flow. (iii) Patients with severe forms of ARVD/C, thrombus formation in the RV and/or spontaneous echocardiographic contrast are at higher risk of a poor outcome.

Keywords: Thromboembolic complications; Arrhythmogenic right ventricular dysplasia/cardiomyopathy; Heart failure.
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