Nora Eccles Harrison Cardiovascular Research & Training Institute

Current Strategies for Managing ARVC Cardiomyopathy

Heart Graphic - Current Strategies for Managing ARVC Cardiomyopathy

Arrhythmogenic right ventricular cardiomyopathy (ARVC), also known as arrhythmogenic cardiomyopathy (ACM) or arrhythmogenic right ventricular dysplasia (ARVC), is a heart condition that tends to be rare. The condition is characterized by some of the myocardial tissue being replaced with fatty or fibrous tissue, especially in the heart’s right ventricle.

There are several challenges in terms of diagnosing and managing ARVC cardiomyopathy since it can present in several ways and may have very severe complications, such as arrhythmias or sudden cardiac death. The strategies usually used with this type of cardiomyopathy include early detection, risk management, and interventions to avoid bad outcomes.

ACM Heart Condition Symptoms

Symptoms of ARVD cardiomyopathy can vary between individuals, which is part of why it can be challenging to diagnose. A few symptoms that patients may experience include chest pain, palpitations, shortness of breath, and syncope. Many of these issues get worse while engaging in physical activity. At the same time, some people do not have any symptoms until the condition gets worse and heart failure or arrhythmias occur.

Most of the clinical manifestations of ARVC aren’t very specific and could be the same as symptoms for other cardiac issues, which makes diagnosis even more complicated. It’s important to consider all the possibilities, especially among patients showing a symptom and with a known genetic disposition or a family history of sudden cardiac death.

How Fast Does ARVD Progress?

It’s hard to say how quickly ARVC can progress since it varies from one person to another. One person might have a minor problem with few symptoms, while another might have quickly deteriorating cardiac function and a life-threatening arrhythmia. Some of the factors that play into the progression of the disease include environmental triggers, genetic factors, and comorbidities like obesity and hypertension.

Among the studies that have been done on ARVD cardiomyopathy, most cases progress across years to even decades. The most unwanted outcomes are common in those who are in an advanced stage of the disease. However, there are still things to learn about this disease, which is why close monitoring is needed for those affected by it.

Arrhythmogenic Cardiomyopathy Health Treatment

Managing ARVC cardiomyopathy involves several steps and must be tailored to each patient and their characteristics, such as genetic profile, severity of the disease, and symptoms. Some of the most important parts of treatment include implantable cardiac devices, pharmacotherapy, lifestyle modification, and catheter-based solutions aimed at preventing the risk of sudden cardiac death and arrhythmias.

Healthy Lifestyle Modifications

People who have ARVC cardiomyopathy are generally asked to avoid extreme physical activity and competitive sports. Either of these things can lead to a heightened risk of sudden cardiac arrest and arrhythmias. Moderate exercise is often recommended, as is a dietary change to keep a healthy weight and manage risk factors like dyslipidemia and hypertension.


Various medications can be prescribed to patients to help with symptoms and reduce the chances of arrhythmias in people with ARVC cardiomyopathy. Beta-blockers are a common choice to prevent tachyarrhythmias and ventricular ectopy, but drugs like sotalol and amiodarone might be used in refractory situations. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) can also be prescribed to prevent adverse ventricular remodeling and manage heart failure.

Implantable Cardiac Devices

Implantable cardioverter-defibrillators (ICDs) can play a huge part in managing ARVC. They can detect and terminate arrhythmias that might be life-threatening to avoid sudden cardiac death. Despite other solutions, these devices are often used for those with a history of sustained ventricular tachycardia, syncope of unknown history, or significant ventricular dysfunction. ICDs are placed with an awareness of the patient’s risk assessment and involve a relationship between the patient and the doctor.

Catheter Ablation

Catheter-based ablation is a procedure that can be used for some patients with ARVC cardiomyopathy to reduce the burden of ventricular arrhythmias and eliminate arrhythmogenic substrates. Cryoablation and radiofrequency techniques can target specific scar-related reentrant circuits or focal triggers, especially in the case of returning ventricular tachycardia refractory to medical therapy. However, the extent to which this treatment can help patients vary, and more research is required to determine long-term success rates and how to optimize patient outcomes.

Final Thoughts

These are the main solutions available for patients with ARVC cardiomyopathy, but research is currently being done to learn more about this disease. Understanding the mechanisms of ARVC, identifying the best biomarkers for risk stratification, and developing targeted health solutions to halt disease progression will all greatly change how this issue is solved.