Table 3.
Category | 2023 TF updates |
---|---|
1. Global or regional dysfunction and structural alteration | LV: the 2nd Minor criterion “Regional LV hypokinesia or akinesia of LV free wall, septum, or both” has been removed. |
2. Tissue characterization | RV: now the specific Major criterion including histologic analysis after EMB is not a limited indication anymore; transmural LGE (non-ischemic pattern) at CMR is now considered as a Minor criterion. |
LV: added a new Major criterion about “Ring-like” LV LGE stria pattern of 3 or more segments; bull’s eye segments LGE involvement has been better defined and is now considered as a Minor criterion. | |
3. Repolarization abnormalities | RV: Major criterion has been better defined (complete pubertal development is now specified as 14-year-old and T wave must not be preceded by J-point/ST-segment elevation); now the old Minor criteria about negative T-wave beyond V3 have been split to include either presence of complete RBBB or 14-year-old individuals. |
4. Depolarization and conduction abnormalities | LV: low QRS voltages criterion is now considered ad Major and has been better defined, specifying the need of exclusion all the other causes of low voltages. |
5. Arrhythmias | RV: among Minor criteria, added “History of cardiac arrest due to ventricular fibrillation or sustained ventricular tachycardia of unknown morphology”. |
LV: relevance is given to exercise-induced ventricular extrasystoles to better define the first Minor criteria; added two new Minor Criteria about non-sustained or sustained ventricular tachycardia with a RBBB morphology (excluding the “fascicular pattern”) and history of cardiac arrest due to ventricular fibrillation or sustained ventricular tachycardia of unknown morphology. | |
6. Family history/genetics | RV/LV: added the identification of a likely-pathogenic ACM-gene variant in the patient under evaluation as a Minor criterion. |
ACM, arrhythmogenic cardiomyopathy; CMR, cardiac magnetic resonance; EMB, endomyocardial biopsy; LGE, late gadolinium enhancement; LV, left ventricle; RBBB, right bundle-branch block; RV, right ventricle; TF, Task Force.