Jørg Saberniak‘s research can be of great value for patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).
- Too much exercise may accelerate cardiac dysfunction in patients with ARVC.
- 24-hour electrocardiogram, echocardiography and cardiac MR are useful tools to improve the diagnosis and treatment of early ARVC, distinguishing it from the benign condition RVOT-VT.
- Identification of early ARVC patients with severe arrhythmias can improve by combining cardiac ultrasound and electrocardiography.
Thesis: Arrhythmogenic right ventricular cardiomyopathy (ARVC)- Impact of exercise on cardiac outcome, differential diagnoses and risk stratification of arrhythmic events.
Candidate: Jørg Saberniak
Time: October 20, 2017 at 13:15
Place: Oslo University Hospital, Rikshospitalet B: Seminar room 2 (B2.U002)
Link to university website (in Norwegian)
Arrhythmogenic right ventricular cardiomyopathy is an inherited disease causing increased formation of fat and connective tissue in the heart. It has a prevalence of about 1:3000 and is one of the most common causes of sudden death in athletes.
(1) Both patients with ARVC and mutation positive family members who exercise a lot have reduced systolic function of both the left and right ventricle, compared to those who exercise less. Much exercise was defined as at least four hours of vigorous exercise each week for a minimum of six years. Moreover, the amount and intensity of exercise was linked to impaired cardiac function.
65 ARVC patients and 45 mutation positive family members were included in the study.
(2) It can be challenging to differentiate between ARVC in its early phase and the benign arrhythmias of right ventricular outflow tract ventricular tachycardia, RVOT-VT. However, Saberniak and co-workers showed that cardiac imaging and Holter-monitoring may help to correctly diagnose early-phase ARVC and RVOT-VT, and thus make sure patients are given the right treatment.
Compared to patients with RVOT-VT, patients with early phase ARVC have lower right ventricular ejection fraction on cardiac MR and increased diameter of the right ventricle measured by cardiac ultrasound. They also have less premature ventricular contractions during 24-hour Holter monitoring.
(3) A combination of parameters from the electrocardiogram and echocardiography improves identification of patients who has experienced arrhtytmic events in the early phase of ARVC. Those with arrhythmic events had larger diameter and more pronounced mechanical dispersion of the right ventricle, in addition to more pathological signal averaged ECGs.
(1) Saberniak, J., Hasselberg, N. E., Borgquist, R., Platonov, P. G., Sarvari, S. I., Smith, H. J., Ribe, M., Holst, A. G., Edvardsen, T., & Haugaa, K. H. (2014). Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members. European journal of heart failure, 16(12), 1337-1344.
(2) Saberniak, J., Leren, I. S., Haland, T. F., Beitnes, J. O., Hopp, E., Borgquist, R., Edvardsen, T., & Haugaa, K. H. (2016). Comparison of patients with early-phase arrhythmogenic right ventricular cardiomyopathy and right ventricular outflow tract ventricular tachycardia. European Heart Journal-Cardiovascular Imaging, 18(1), 62-69.
(3) Leren, I. S., Saberniak, J., Haland, T. F., Edvardsen, T., & Haugaa, K. H. (2017). Combination of ECG and echocardiography for identification of arrhythmic events in early ARVC. JACC: Cardiovascular Imaging, 10(5), 503-513.