7th March 2024

Treatment

Heart failure in the context of ARVC should be treated as per guidelines with optimal medical therapy as described above for DCM.

In the context of relatively low levels of electrical abnormalities, antiarrhythmic beta blockers such as sotalol or amiodarone are effective at controlling arrhythmias.

For patients with episodes of sustained VT or any episodes of VF, drugs can be trialed to reduce their likelihood, with EP studies to assess for continued inducibility of malignant arrhythmias. In certain patients, catheter ablation can also be considered.

For those in whom these arrhythmias remain inducible, those with overt arrhythmias outside of the EP setting, or in those with severe systolic dysfunction of either ventricle, an implantable cardiac defibrillator is typically required and is effective in preventing arrhythmogenic sudden death.

As per DCM, patients with end-stage heart failure may need consideration for device therapy or transplantation.