The importance of anti-fibrotic drugs as first-line therapy in patients with arrhythmogenic right ventricular dysplasia

We read with interest a study by Cappelletto et al., which emphasized the importance of achieving the target dose of beta-blocker therapy in patients with arrhythmogenic right ventricular dysplasia (ARVD) [1]. ARVD is characterized by a progressive displacement of cardiomyocytes in the right ventricle with fatty and fibrous tissue [2]. Furthermore, ARVD is an under-diagnosed disease and should be considered in patients with unexplained exertion dyspnoea [2]. Implantable cardioverter-defibrillator (ICD) is the cornerstone treatment in such patients [1].