Language

English

Publication Date

10-1-2025

Journal

JACC: Case Reports

DOI

10.1016/j.jaccas.2025.105306

PMID

41043920

PMCID

PMC12540268

PubMedCentral® Posted Date

10-1-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: A healthy 44-year-old woman presented for preoperative evaluation of planned bunionectomy. Electrocardiogram showed T-wave inversions in leads V1 to V5 and epsilon waves in precordium prompting further evaluation.

Case summary: Imaging studies and genetic testing revealed diagnosis of arrhythmogenic right ventricular cardiomyopathy. Patient met Class IIb indication for primary prevention with implantable cardioverter-defibrillator (ICD). Despite weak guideline indication, shared decision-making with the patient led to ICD implantation. Six months later, she had a ventricular tachycardia arrest resulting in ICD shock and return to sinus rhythm.

Discussion: Routine preoperative evaluation led to the diagnosis of a rare pathology. Prompt evaluation and intervention using shared decision-making led to a life-saving intervention.

Take-home messages: Utilization of guidelines in conjunction with patient-centered therapy is the best approach to provide optimal care and prevent mortality in rare instances like this case for ICD placement after arrhythmogenic right ventricular cardiomyopathy diagnosis.

Keywords

cardiomyopathy, cardioversion, electrophysiology, right ventricle, ventricular tachycardia

Published Open-Access

yes

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Graphical Abstract

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