A novel treatment strategy for therapy refractory ventricular arrhythmias in the setting of arrhythmogenic right ventricular dysplasia

Abstract

Arrhythmogenic right ventricular dysplasia (ARVD) is a major cause of ventricular tachycardia and cardiac arrest in young adults. The ideal management of this genetic disorder is individual. The treatment options are antiarrhythmic drug therapy, transcatheter radiofrequency catheter ablation, implantable cardioverter defibrillator therapy, and surgical treatment [Kies P, Bootsma M, Bax J, Schalij MJ, van der Wall EE. Arrhythmogenic right ventricular dysplasia/cardiomyopathy: screening, diagnosis, and treatment. Heart Rhythm 2006;3:225-34; Verma A, Kilicastan F, Schweikert RA et at. Short- and Long-term success of substrate-based mapping and ablation of ventricular tachycardia in arrhythmogenic right ventricular dysplasia. Circulation 2005;111:3209-16]. In the following, we describe a unique case of a young patient, presenting with therapy refractory ventricular arrhythmias in the setting of ARVD, who following failed catheter ablations, has been successfully treated with beating heart cryoablation.