aneurysms

Hello, I am a 24 year old female who use to have 24000-35000 PVC's from the RVOT a day.  I have had many episodes of syncope, near syncope, dizzyness, extreme weakness, racing heart, chest pain etc.  I also have a brother that passed away suddenly at only a few months of age from what was thought to be SIDS.  My cardiologist then ordered a cardiac MRI (at canada's top cardiovascular center).  The initial report stated that they found "localized RV aneurysms on the RV free wall".  Because i had now met one major criteria for ARVC/D (the aneurysms) and one minor criteria (# of PVC's) and have a positive family history for SCD, he thought an ICD was needed.  I was then sent back to the cardiovascular center where they preformed an signal averaged ECG which came back normal.  They then did a heart cath, angiogram and RV angiogram which they said were slightly abnormal (no more details were given). They then did an EP study which they said was not consistant with ARVC.  Instead, they found RVOT PVC's and AV nodal reentry tachycardia, both which they were able to sucessfully ablate.  The cardiologists then went and looked at the MRI themselves and not just the report.  They said that they are not certain that i actually have an Aneurysm.  They said that as far as they are concerned they do not believe that i have ARVC and that they i should have an MRI done annually to make sure they were not too quick to rule out ARVC.  So now i am confused.  Is it possible for the MRI reader (who is considered the best in canada) to initially say that there was an  RV aneurysm and then later have my cardiologists say that they are likely non existent?  If i do not have an aneurysm, why would the initial report state that i did?  Could he have mistaken it for something else?  Should i just trust them and forget about ARVC until the next MRI, one year from now?  Any information or insight would be greatly appriciated!

[Douglas Bogart, MD]

You have a difficult and unusual problem.  If the arrhythmia has gone away it likely was from the RVOT and not from ARVC.  The MRI and the RV angio should be the best way to exclude ARVC.  I would ask your cardiologist to talk with the MRI doctor and see if they could come to a consensus opinion.