{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T07:11:13Z","timestamp":1776064273827,"version":"3.50.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T00:00:00Z","timestamp":1637539200000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/18\/28\/33549"],"award-info":[{"award-number":["FS\/18\/28\/33549"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Arrhythmogenic left ventricular cardiomyopathy (ALVC) is a rare form of arrhythmogenic cardiomyopathy characterized by fibrofatty replacement of left ventricular myocardium, malignant arrhythmia, and sudden cardiac death. The definition incorporates several genetic causes, including pathogenic variation in the Filamin C gene (FLNC). Although awareness of ALVC has improved, identification remains challenging and diagnostic criteria continue to evolve.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 50-year-old athletic male was admitted following an out-of-hospital cardiac arrest due to ventricular tachycardia (VT) whilst playing football. Coronary angiography revealed unobstructed epicardial vessels and the diagnosis of ALVC was suggested by cardiovascular magnetic resonance imaging, which demonstrated a mildly dilated and moderately impaired left ventricle with epicardial late gadolinium enhancement in the basal to mid-lateral walls and subendocardial septum. Initial testing with a cardiomyopathy and arrhythmia gene panel was negative but extended testing uncovered a likely pathogenic variant in FLNC. Subsequently, the patient experienced a recurrence of sustained VT necessitating implantable cardioverter-defibrillator (ICD) therapies, ultimately undergoing a combined epicardial and endocardial VT ablation 4 years after presentation. Six months post-ablation, he was asymptomatic and his arrhythmia rendered quiescent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Arrhythmogenic cardiomyopathy should be considered in the evaluation of an initially unexplained cardiac arrest. This case characterizes the clinical features of a patient with FLNC cardiomyopathy and emphasizes the utility of genetic testing using modern gene panels in patients with comparable phenotypes. We also demonstrate that optimal medical therapy with antiarrhythmic drugs, exercise restriction, ICD insertion, and catheter ablation can be useful in the management of ALVC with positive outcomes<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab422","type":"journal-article","created":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T03:08:47Z","timestamp":1639192127000},"source":"Crossref","is-referenced-by-count":3,"title":["Cardiac arrest as first presentation of arrhythmogenic left ventricular cardiomyopathy due to Filamin C mutation: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9995-1639","authenticated-orcid":false,"given":"Navneet","family":"Kandhari","sequence":"first","affiliation":[{"name":"St Georges University Hospital NHS Foundation Trust , Blackshaw Road, Tooting, London SW17 0QT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5190-9407","authenticated-orcid":false,"given":"Shafik","family":"Khoury","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Institute, St George\u2019s University of London , Cranmer Terrace, Tooting, London SW17 0RE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8731-2853","authenticated-orcid":false,"given":"Elijah R","family":"Behr","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Institute, St George\u2019s University of London , Cranmer Terrace, Tooting, London SW17 0RE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8192-5739","authenticated-orcid":false,"given":"Chris","family":"Miles","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Institute, St George\u2019s University of London , Cranmer Terrace, Tooting, London SW17 0RE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,11,22]]},"reference":[{"key":"2022081608412729400_ytab422-B1","doi-asserted-by":"crossref","first-page":"e301","DOI":"10.1016\/j.hrthm.2019.05.007","article-title":"2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy","volume":"16","author":"Towbin","year":"2019","journal-title":"Heart Rhythm"},{"key":"2022081608412729400_ytab422-B2","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1161\/CIRCULATIONAHA.118.037230","article-title":"Sudden death and left ventricular involvement in arrhythmogenic cardiomyopathy","volume":"139","author":"Miles","year":"2019","journal-title":"Circulation"},{"key":"2022081608412729400_ytab422-B3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.ijcard.2019.09.048","article-title":"Filamin C variants are associated with a distinctive clinical and immunohistochemical arrhythmogenic cardiomyopathy phenotype","volume":"307","author":"Hall","year":"2020","journal-title":"Int J Cardiol"},{"key":"2022081608412729400_ytab422-B4","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1002\/humu.24004","article-title":"A mutation update for the FLNC gene in myopathies and cardiomyopathies","volume":"41","author":"Verdonschot","year":"2020","journal-title":"Hum Mutat"},{"key":"2022081608412729400_ytab422-B5","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1161\/CIRCULATIONAHA.104.532234","article-title":"Novel mutation in desmoplakin causes arrhythmogenic left ventricular cardiomyopathy","volume":"112","author":"Norman","year":"2005","journal-title":"Circulation"},{"key":"2022081608412729400_ytab422-B6","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1161\/CIRCULATIONAHA.115.017284","article-title":"Arrhythmogenic left ventricular cardiomyopathy: suspected by cardiac magnetic resonance imaging, confirmed by identification of a novel plakophilin-2 variant","volume":"132","author":"Saguner","year":"2015","journal-title":"Circulation"},{"key":"2022081608412729400_ytab422-B7","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1016\/j.jacc.2008.09.019","article-title":"Left-dominant arrhythmogenic cardiomyopathy. 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