PMC9098832_01
Holter electrocardiogram (ECG) on admission showed three consecutive episodes of ventricular premature beats (A) and ventricular tachycardia (VT) (B); Twelve-lead ECG after VT termination indicated sinus rhythm (C).
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F1
ECG suggested VT and the ventricle angiography showed dilated right ventricle (LV) (Figure 1). Echocardiography revealed normal LV size and function. Figure 1). Four years after the ICD implantation, the patient felt palpitations accompanied by discomfort in the precordial area.
Transthoracic echocardiography (TTE) shows three anatomical components, including thin compacted layer, prominent intracardiac trabeculae (the red arrow) and deep intertrabecular recesses. The measured ratio of non-compacted to compacted myocardium was 2.7:1 (A); Color Doppler echocardiography reveals deep recesses communicated with the Right ventricle (RV) cavity (the green arrow) (B).
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F2
Furthermore, the measured ratio of non-compacted to compacted myocardium (NC/C) was 2.7:1 (Figure 2). Ensuing, we reviewed the videos of coronary angiography from the local hospital, which demonstrated a smooth intima and no stenosis, excluding the possibility of obstructive coronary artery disease (Supplementary Figure 2).
Right ventricle (RV) angiography revealed a dilated RV, excessive trabeculae and deep recesses with the retention of contrast agent at the apex and outflow tract of RV (A) (yellow arrow: trabeculae; red arrow: deep intertrabecular recesses), while no abnormality in left ventricle (LV) (B).
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No abnormality was observed in the LV (Figure 3).
Contrast Computed tomography (CT) revealed abnormally dilated right ventricle (RV) and right atrium (RA), multiple protruding low-density intracardiac trabeculae attached to wall of the RV, and the high-density contrast agent in intertrabecular recesses and RV cavity (A-F) [green arrow: trabeculae (A-F); red arrow: ICD lead (A,C,E)]; The left ventricle (LV) myocardium is thickened, and the trabeculae is normal (A-F).
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The LV myocardium is slightly thickened, and the trabeculae is normal (Figure 4).
The detailed timeline of this patient from the symptom onset to follow-up. ECG, electrocardiogram; VT, ventricular tachycardia; TTE, transthoracic echocardiography; ICD, implantable cardioverter-defibrillator; RV, right ventricle; CT, computed tomography; LV, left ventricle; RVNC, right ventricular non-compaction.
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The detailed timeline of this patient from symptom onset to follow-up is illustrated in Figure 5.