Algorithm showing the approach to medical management of patients with ARVC*

ARVC: arrhythmogenic right ventricular cardiomyopathy; ICD: implantable cardioverter-defibrillator; LV: left ventricular; ACE: angiotensin converting enzyme; ARB: angiotensin II receptor blocker.
* All patients with definite ARVC should be restricted from vigorous activity, and first-degree relatives of the proband should be screened. Refer to UpToDate content on ARVC treatment for additional details.
¶ All patients should have been evaluated for risk of sudden cardiac death and potential need for an ICD prior to medical therapy.
Δ Antiarrhythmic drug options in ARVC include sotalol, flecainide, and amiodarone. Refer to UpToDate content on ARVC treatment for additional details.
◊ If patient has ventricular arrhythmias and has not had an ICD, referral for ICD implantation should occur.
§ Refer to UpToDate content on treatment of heart failure with reduced LV function. Standard heart failure therapy may include beta blocker, ACE inhibitor or ARB, aldosterone antagonist, and diuretics.