Risk Factors and Predictors of Ventricular Tachycardia in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy: Insights from a Pakistani Cohort

Objectives: This study aimed to identify risk factors and predictors of ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) treated at Hayatabad Medical Complex, Peshawar. Methodology: A retrospective cohort analysis was performed on 150 ARVC patients diagnosed between January 2019 and June 2024. Key variables included electrocardiographic findings (e.g., T-wave inversions), NT-proBNP levels, genetic mutations (PKP2, DSP), and echocardiographic parameters. Predictors were assessed using univariate and multivariate Cox proportional hazards models. Results: The mean age of the cohort was 45 years, with 60% male. Significant predictors of VT included older age (HR 1.05, p<0.001), male gender (HR 1.75, p=0.002), T-wave inversions on ECG (HR 2.15, p<0.001), and elevated NT-proBNP levels (HR 1.01 per 100 pg/ml increase, p=0.005). During follow-up, 30% of patients experienced VT, 20% developed sustained ventricular arrhythmias, and 10% mortality was observed. Conclusion: Age, male gender, T-wave inversions, and elevated NT-proBNP levels were identified as significant predictors of VT in ARVC patients. These findings highlight the critical role of biomarker testing and electrocardiographic monitoring in improving risk stratification and management for ARVC, particularly in resource-constrained settings.