IMR Press / RCM / Volume 15 / Issue 3 / DOI: 10.3909/ricm0657

Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with MedReviews, LLC.

Open Access Review
Guiding the Management of Ventricular Arrhythmias in Patients With Left Ventricular Noncompaction Cardiomyopathy: A Knowledge Gap
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1 Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI
2 Health Care Partners, Greenslopes Private Hospital, Greenslopes, Queensland, Australia
Rev. Cardiovasc. Med. 2014, 15(3), 208–216; https://doi.org/10.3909/ricm0657
Published: 30 September 2014
Abstract
Left ventricular noncompaction (LVNC) is a cardiomyopathy that occurs due to an arrest of myocardial maturation during embryogenesis. The diagnostic echocardiographic features in individuals with LVNC include a thick, bilayered myocardium, prominent ventricular trabeculations, and deep intertrabecular recesses. Clinical features associated with LVNC vary in asymptomatic and symptomatic patients, and include the potential for heart failure, conduction defects (eg, left bundle branch block), supraventricular and ventricular arrhythmias, thromboembolic events, and sudden cardiac death. The authors report five cases that emphasize asymptomatic and apparently benign symptoms in patients with LVNC; despite normal physical examination and 12-lead electrocardiogram results, all of these cases unveiled potentially serious clinical consequences. These cases highlight the concern that LVNC patients with mild to moderate left ventricular systolic dysfunction, particularly in the presence of ventricular arrhythmias or a family history of sudden cardiac death, may need consideration for an implantable cardioverter defibrillator (ICD). All potential benefits of an ICD need to be balanced by the risk of device infection, lead and device malfunction, and potential for inappropriate shocks
Keywords
Left ventricular noncompaction
Ventricular tachycardia
Heart failure
Sudden cardiac death
Echocardiography
Noncompacted myocardium
Exercise testing
Rhythm disturbance surveillance
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