AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 40 Submission ID: 1553 ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY REVEALED BY VENTRICULAR TACHYCARDIA ETTACHFINI TAHA, OUARRAK SAFIA, COUISSI ABDESSAMAD, HABOUB MERYEM, AROUS SALIM, BENOUNA MOHAMED EL GHALI, AZZOUZI LEILA, HABBAL RACHIDA MOROCCO Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetically determined cardiomyopathy characterized by fibrofatty replacement of the myocardium. The severity of the disease is related to fatal arrythmias, mainly monomorphic Ventricular Tachycardia (VT). The diagnosis is based on a constellation of criteria, based on imaging by echocardiography, Magnetic Resonance Imaging (MRI) or Right Ventricular angiography, on electrical abnormalities and endomyocardial biopsy. The aim of the treatment is to prevent ventricular arrythmias and sudden cardiac death (SCD); It consists of anti-arrhythmic drugs and Implantable Cardiac Defibrillator (ICD). Case presentation: We report the case of a 23-year-old woman, with a history of palpitations and a familial history of SCD, who presented to the emergency department with hemodynamically unstable VT. After successful electrical cardioversion, clinical examination did not show signs of heart failure, the electrocardiogram revealed a complete right bundle branch block pattern with prolonged QTc interval. Echocardiography showed an enlarged Right Ventricle (RV), with important trabeculations and apical hypokinesis. The global RV function was normal. The left ventricular function was impaired with a global hypokinesis, the Ejection Fraction (EF) was at 35% using the Simpson Biplane (SB) method. The cardiac MRI revealed bilateral ventricular dilation, thinning and dysfunction, along with fatty impactions on the RV. The EF of the Left Ventricle (LV) was at 30,56% and that of the RV at 7.8%. The diagnosis of arrhythmogenic right ventricular cardiomyopathy was immediately made. After restoration of the normal sinus rhythm by electrical cardioversion, the patient received 900 mg/ 24h IV drip maintaining dose of amiodarone, followed by oral maintenance dose which was progressively decreased to 400mg/day, along with the introduction of bisoprolol 10mg o.d. Due to the high risk of SCD, the patient received an ICD and she remained asymptomatic at the threemonth follow-up visit. Conclusion: In our case, ARVC was diagnosed following an episode of VT, which is the most common form of presentation of the disease. The diagnosis was made through imaging criteria by echocardiography and cardiac MRI. For management, the patient received antiarrhythmic drugs and ICD implantation. Key words: Arrhythmogenic right ventricular cardiomyopathy, Ventricular arrythmias, Sudden cardiac death, Palpitations, Implantable Submission ID: 1554 ATRIAL FIBRILLATION AFTER ISCHEMIC STROKE DETECTED BY 24 HOURS CHEST HOLTER MONITORING Z.BOUDHAR, H.ROUAM, M.EL JAMILI, M. EL HATTAOUI MOROCCO Background: Atrial fibrillation (AF) is a major risk factor for recurrent ischaemic stroke, but often remains undiagnosed in patients who have had a documented ischaemic stroke.Holter-electrocardiogram-monitoring might increase detection of atrial fibrillation. Objective: This present study aimed to investigate the diagnostic yield of 24 hours chest holter monitor by determing the prevalence of covert AF in patients who previously had an ischemic stroke. Methods: A total of 62 patients who had ischemic stroke without previously documented AF were collected from the register of holterelectrocardiogram monitoring in the non-invasive exploration unity of university hospital center Mohammed VI of Marrakech, from January 2016 and December 2020. All patients included were screened for AF using 12-lead ECG and 24 hours Holter monitoring. Results: 24 hours Holter monitoring uncovered AF in 6 of 62 patients (9,6%) with median age of 61 (+/- 10,8) and male predominance. AF was permanent within 5 patients and paroxysmal in 1 patient, whereas 12-lead ECG uncovered AF in 1 patient (1,6%). other rythm and conduction abnormalities were detected in 35,4% of cases and in 55% of cases, the 24-holter ECG recordings were normal. Conclusion: The prevalence of covert AF in our study is 9,6%. The duration Holter-ECG recording time is 24 hours. In patients with ischaemic stroke, monitoring for AF is recommended by short-term ECG recording followed by continuous ECG monitoring for at least 72 h, also considering a tiered longer ECG monitoring if necessary. Which is difficult to apply in our context given the limited resources and the unavailability of implantable monitors and long-term recorders. MODERATED POSTER SESSION
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