Ventricular Flutter and Pleomorphic Ventricular Tachycardia-Induced Syncope in Borderline Arrhythmogenic Right Ventricular Cardiomyopathy

Mason Marcus; Richard Wu; Mark S Link; Benjamin D Levine

doi:10.1016/j.jaccas.2022.07.027

Ventricular Flutter and Pleomorphic Ventricular Tachycardia-Induced Syncope in Borderline Arrhythmogenic Right Ventricular Cardiomyopathy

JACC Case Rep. 2022 Sep 7;4(17):1134-1139. doi: 10.1016/j.jaccas.2022.07.027.

Authors

Mason Marcus¹, Richard Wu¹, Mark S Link¹, Benjamin D Levine^{1

2}

Affiliations

¹ University of Texas Southwestern Medical Center, Dallas, Texas, USA.
² Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas, USA.

Abstract

A 20-year-old female competitive collegiate swimmer presented after 2 postexercise syncopal episodes and 1 episode while actively swimming. Ambulatory monitoring and exercise testing revealed nonsustained ventricular tachycardia. Electroanatomic mapping demonstrated multifocal premature ventricular contractions and ventricular flutter originating from the right ventricular outflow tract, consistent with borderline arrhythmogenic right ventricular cardiomyopathy. (Level of Difficulty: Intermediate.).

Keywords: CMR, cardiac magnetic resonance; ECG, electrocardiogram; ICD, implantable cardioverter-defibrillator; LBBB, left bundle branch block; NSVT, nonsustained ventricular tachycardia; PVC, premature ventricular complex; RV, right ventricular; RVOT, right ventricular outflow tract; VT, ventricular tachycardia; cardiomyopathy; electroanatomic mapping; genetics.

Publication types

Case Reports