Perioperative outcomes in patients with arrhythmogenic right ventriclar cardiomyopathy undergoing noncardiac surgery: a case series and recommendations

Editor—Unexpected perioperative cardiac arrest is a devastating outcome for the patient, their family, and the healthcare team. Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a significant cause of heart failure that can complicate the intraoperative period with ventricular arrhythmias. This uncommon disease, initially reported in the 1970s, has an incidence of 1 in 5000, and can be present in otherwise asymptomatic individuals. 1 Gandjbakhch E. Redheuil A. Pousset F. Charron P. Frank R. Clinical diagnosis, imaging, and genetics of arrhythmogenic right ventricular cardiomyopathy/dysplasia. J Am Coll Cardiol. 2018; 72: 784-804 Crossref PubMed Scopus (151) Google Scholar , 2 Corrado D. Link M.S. Calkins H. Arrhythmogenic right ventricular cardiomyopathy. N Engl J Med. 2017; 376: 61-72 Crossref PubMed Scopus (360) Google Scholar , 3 Gupta R. Tichnell C. Murray B. et al. Comparison of features of fatal versus nonfatal cardiac arrest in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy. Am J Cardiol. 2017; 120: 111-117 Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar It is likely that an anaesthetist will encounter patients with this condition during their career. We cared for a young adult on the path to becoming a professional basketball player who suffered an unexpected cardiac arrest during practice. After managing this patient's anaesthesia from automatic implantable cardioverter defibrillator (AICD) implantation through an orthotopic heart transplant, we decided to study the perioperative implications of this condition in more depth.