Arrhythmogenic Right Ventricle in Left Ventricular Non-compaction - In Response to the Letter to the Editor "Diagnostic Dilemmas for Underlying Pathophysiology of Arrhythmias Originating from the Right Ventricle"

We would like to thank the author for their interest in our manuscript [1] as well as for their considerate comments. Our patient initially presented in another center with ventricular ectopics (VEs) that were mapped and ablated from the right ventricular outflow tract. The second arrhythmia foci had left bundle branch block morphology but different axis, and it was mapped and ablated by us at the base of the RV towards the infero-lateral aspect of the tricuspid annulus. We share the authors' opinion that in patients with multiple arrhythmia foci from different parts of the RV myocardium ARVD/C should be considered and notably, that was our initial presumptive diagnosis; however, other features should be identified to further support the diagnosis or ARVD/C. The existing diagnostic criteria are based on major and minor points including structural parameters identified on cardiac magnetic resonance (CMR) or 2D echocardiogram, histological features on myocardial biopsy, depolarization or repolarization abnormalities on ECG, often occurring in a context of familial disease [2].