Patient handout

Arrhythmogenic RV / biventricular cardiomyopathy (ARVC/ALVC, chronic)

PRODUCTION

1. Your condition

This handout is for arrhythmogenic rv / biventricular cardiomyopathy (arvc/alvc, chronic). Your care team identified this based on: echo/cmr: rv dilatation/dysfunction/regional aneurysm (± lv lge).

Other reasons your team may use this plan: ecg: t-wave inversion v1–v3, epsilon wave, terminal activation delay; lbbb-morphology vt / frequent pvcs / palpitations; exertional syncope or aborted scd.

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
exercise restriction (no competitive / high-intensity endurance exercise)	—	—	—	2019 HRS — endurance/competitive exercise accelerates structural progression + arrhythmia and increases SCD; restriction is disease-modifying even in phenotype-negative carriers

Plan: ARVC SCD-prevention + VA management (2019 HRS Arrhythmogenic CM; 2023 ESC Cardiomyopathy)

3. When to call your provider

Contact your care team if any of the following happen:

Sustained VT/VF / arrhythmic syncope → EP + ICD now — 2019 HRS
Progressive RV/biventricular failure → advanced HF / transplant — 2023 ESC Cardiomyopathy
Electrical storm → emergency (post-arrest ARVC pathway) — 2019 HRS

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

Prior sustained VT/VF or aborted SCD — secondary-prevention ICD Class I — 2019 HRS(life-threatening)
Arrhythmic syncope / NSVT / significant RV or LV dysfunction / high Cadrin-Tourigny score — primary-prevention ICD consideration — 2019 HRS
TMEM43 / PLN / FLNC / DSP variant — malignant arrhythmic phenotype; lower ICD threshold even with modest phenotype — 2023 ESC Cardiomyopathy
Athlete / high-intensity endurance exposure — strict exercise restriction (disease-modifying), shared-decision sports counseling — 2019 HRS
Pregnancy with ARVC — continue beta-blocker, ICD compatible, intensified arrhythmia monitoring; multidisciplinary — ESC 2018 Pregnancy
End-stage RV/biventricular failure or intractable VT despite therapy — transplant evaluation — 2023 ESC Cardiomyopathy(life-threatening)

5. Follow-up

Family cascade screening; genotype-specific surveillance of at-risk relatives; lifelong exercise counseling

6. Sources

Guideline: 2019 HRS Arrhythmogenic Cardiomyopathy Expert Consensus + 2023 ESC Cardiomyopathy Guideline; 2010 modified Task Force Criteria