IJCS | Volume 31, Nº6, November / December 2018

671 1. Sem-Chowdhry S, Morgan RD, Chambers JC, McKenna WJ. Arrhythmogenic cardiomyopathy: etiology, diagnosis, and treatment. Annu Rev Med. 2010;61:233-53. 2. Hulot JS, Jouven X, Empana JP, Frank R, Fontaine G. Natural history and risk stratification of arrhythmogenic right ventricular dysplasia/ cardiomyopathy. Circulation. 2004;110(4):1879-84. 3. Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol. 2006;48(5):e247-346. 4. Niroomand F, Carbucicchio C, Tondo C, Riva S, Fassini G, Apostolo A, et al. Electrophysiological characteristics and outcome in patients with idiopathic right ventricular arrhythmia compared with arrhythmogenic right ventricular dysplasia. Heart. 2002;87(1):41-7. 5. Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/ dysplasia: proposed modification of the task force criteria. Circulation. 2010;121(13):1533-41. 6. Gemayel C, Pelliccia A, Thompson PD. Arrhythmogenic right ventricular cardiomyopathy. J Am Coll Cardiol. 2001;38(7):1773-81. 7. Abecasis J, Masci PG, Aquaro GD, Pingitore A, De Marchi D, Lombardi M. Arrhythmogenic biventricular dysplasia? Rev Port Cardiol. 2009;28(12):1459-63. 8. Tandri H, Saranathan M, Rodriguez ER, Martinez C, Bomma C, Nasir K, et al. Noninvasive detection of myocardial fibrosis in arrhythmogenic right ventricular cardiomyopathy using delayed-enhancement magnetic resonance imaging. J Am Coll Cardiol. 2005;45(1):98–103. 9. Satoh H, Sano M, Suwa K, Saitoh T, Nobuhara M, Saotome M, et al. Distribution of late gadolinium enhancement in various types of cardiomyopathies: Significance in differential diagnosis, clinical features and prognosis. World J Cardiol. 2014;6(7):585-601. 10. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/AmericanHeartAssociationTaskForceonPracticeGuidelines and the Heart Rhythm Society. Circulation. 2013;127(3):e283-e352. References Augusto et al. Biventricular arrhythmogenic cardiomyopathy Int J Cardiovasc Sci. 2018;31(6)667-671 Case Report This is an open-access article distributed under the terms of the Creative Commons Attribution License the current diagnostic criteria for this cardiomyopathy, although being the most unanimous and accepted ones, are based on data from a relatively small series of patients, in which the respective diagnostic sensitivities and specificities of each criterion were evaluated. The main therapeutic goal in these patients is the prevention of malignant arrhythmias and, consequently, of sudden cardiac death, which is the most feared complication. The ICD plays a key role in the secondary prevention of sudden cardiac death, being associated with longer survival in these patients. 10 Patients with biventricular involvement and good functional status are potential candidates for ICD implantation, even in the absence of ventricular arrhythmias. However, how biventricular involvement in this setting may impact on the follow-up, the therapeutic approach, referral for ICD implantation, and patient prognosis should remain to be established. Conclusions Although the current diagnosis criteria are the most widely accepted ones, they focus mainly on the right ventricular phenotype. The use of late enhancement in cardiac magnetic resonance in this patient was essential for the diagnosis and assessment of the left ventricular involvement extent. This tool allows a broader use of the current diagnosis criteria for this disease. Author contributions Conception and design of the research: Augusto J, Abecasis J. Writing of the manuscript: Augusto J, Abecasis J. Critical revision of the manuscript for intellectual content: Abecasis J, Gil V. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associated with any thesis or dissertation work.