Is cardiac MRI an effective test for arrhythmogenic right ventricular cardiomyopathy diagnosis?

Table 1 Task force criteria for the diagnosis of arrhythmogenic right ventricular cardiomyopathy[19]

1 Global and/or regional dysfunction and structural alterations (detected by echocardiography, angiography, magnetic resonance imaging, or radionuclide scintigraphy)

Major: Severe dilatation and reduction of right ventricular ejection fraction with no (or only mild) left ventricular impairment. Localized right ventricular aneurysms (akinetic or dyskinetic areas with diastolic bulging). Severe segmental dilatation of the right ventricle

Minor: Mild global right ventricular dilatation and/or ejection fraction reduction with normal left ventricle Mild segmental dilatation of the right ventricle Regional right ventricular hypokinesia

2 Tissue characterization of wall

Major: Fibro-fatty replacement of myocardium on endomyocardial biopsy

3 Repolarisation Abnormalities

Minor: Inverted T waves in right precordial leads (V2 and V3) in people aged > 12 yr, in absence of right bundle branch block

4 Depolarization/conduction abnormalities

Major: Epsilon waves or localized prolongation (> 110 ms) of the QRS complex in right precordial leads (V1-V3)

Minor: Late potentials (signal-averaged ECG)

5 Arrhythmias

Minor: Left bundle branch block type ventricular tachycardia (sustained and non-sustained) by ECG, Holter or exercise testing. Frequent ventricular extra-systoles (> 1000/24 h) by Holter

6 Family history

Major: Familial disease confirmed at necropsy or surgery

Minor: Family history of premature sudden death (< 35 yr) due to suspected right ventricular dysplasia. Familial history (clinical diagnosis based on present criteria)

The diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC) would be fulfilled in the presence of 2 major criteria or 1 major plus 2 minor or 4 minor criteria from the different groups. ECG: Electrocardiogram.