Publish in this journal
Journal Information
Vol. 73. Issue 11.
Pages 952 (November 2020)
Download PDF
More article options
Vol. 73. Issue 11.
Pages 952 (November 2020)
ECG Contest
Full text access
Response to ECG, October 2020
Respuesta al ECG de octubre de 2020
Francisco Ribes
Corresponding author

Corresponding author:
, Ángel Martínez-Brótons, Ricardo Ruiz-Granell
Unidad de Arritmias, Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain
Related content
Rev Esp Cardiol. 2020;73:84710.1016/j.rec.2020.03.023
Francisco Ribes, Ángel Martínez-Brótons, Ricardo Ruiz-Granell
Article information
Full Text
Download PDF
Full Text

The correct solution is number 4. Palpitations and exercise-induced presyncopal sensation, along with frequent ventricular extrasystoles and repolarization changes in the right precordial leads, is a strong indicator of arrhythmogenic cardiomyopathy. Gadolinium uptake in the right ventricular free wall is associated with a particularly serious condition and risk of sudden cardiac death.1 Progressive onset of tachycardia is observed during exercise with a sharp decrease in cycle length once tachycardia becomes established (response 1, incorrect). Tachycardia presents with pleomorphism and, after several beats, becomes regular (response 2, incorrect). Finally, the cycle length (260-270ms) is not typical of atrial flutter (response 3, incorrect). Genetic testing was performed. Heterozygous PKP2 mutation, which is typical of arrhythmogenic cardiomyopathy, was detected. A dual-chamber defibrillator was implanted,2 and treatment initiated with sotalol. Genetic screening of family members was performed and exercise was contraindicated.

A. Pelliccia, D. Corrado, A. Bjørnstad, et al.
Recommendations for participation in competitive sport and leisure-time physical activity in individuals with cardiomyopathies, myocarditis and pericarditis.
Eur J Cardiovasc Prev Rehabil., 13 (2006), pp. 876-885
D. Corrado, H. Calkins, M.S. Link, et al.
Prophylactic implantable defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy/displasia and no prior ventricular fibrillation or sustained ventricular tachycardia.
Circulation., 122 (2010), pp. 1144-1152
Copyright © 2020. Sociedad Española de Cardiología
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

View newsletter history
Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?