Arrhythmogenic right ventricular cardiomyopathy characterized by recurrent syncope during exercise: A case report

Figure 1 Twelve-lead electrocardiogram findings at admission and after drug cardioversion. A: An electrocardiogram at admission revealed ventricular tachycardia (192 beats per minute) with a superior axis (positive QRS in lead aVL and negative QRS in leads II, III, and aVF), indicating an origin in the inferior wall of the right ventricle; B: An electrocardiogram after drug cardioversion showed a regular sinus rhythm at 65 beats per minute with negative T waves and a delayed S-wave upstroke (60 ms) from leads V1 to V4.

Figure 2 Coronary angiographic results. A and B: Mild atherosclerotic changes in the left anterior descending artery (orange arrow) and no obvious atherosclerotic changes in the left main trunk and left circumflex coronary artery (white arrow); C: Mild atherosclerotic changes in the right coronary artery (black arrow).

Figure 3 Cardiac magnetic resonance imaging in different views showed right ventricular free wall thinning, right ventricular dilatation, fibrofatty infiltration and regional right ventricular aneurysm. A: Fibrofatty infiltration (white arrow); B: Regional right ventricular aneurysm (orange arrow). RV: Right ventricle; LV: Left ventricle.

Figure 4 Electrophysiological study results. A: Multiple inducible right ventricular tachycardias of a focal mechanism; B and C: Endocardial (B) and epicardial (C) 3D-electroanatomic voltage mapping demonstrated scar tissue in the anterior wall, free wall and posterior wall of the right ventricle (gray area); D: 3D electroanatomic voltage mapping showed late potentials (red arrow); E: The focal mechanism of ventricular tachycardia was shown.