<HTML><BODY style="word-wrap: break-word; -khtml-nbsp-mode: space; -khtml-line-break: after-white-space; "><DIV><FONT class="Apple-style-span" face="Arial">Dr. Cannom,</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Thank you for the case study...</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">You noted:</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">"PVC's...suppressed with exercise"...</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">"but at noon he had a seizure and CPR was initiated by a colleague"</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Over the course of nearly 8 years, numerous ARVD diagnosed people, </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">group members, have mentioned that their PVCs "go away" when they begin </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">to exercise a little. Others have mentioned that exercise can take </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">them quickly into VT (i.e. hopping on an exercise bicycle, doing a few </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">moves of Tae Kwon Do.)</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Numerous members have mentioned that when they have had VT and </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">subsequently fainted, that those who were with them said they appeared </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">to be having a "seizure"</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">The questions are:</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">1. Is it well known that some patients with frequent PVCs often notice </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">that they go away during exercise of some sort, i.e. raise in heart </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">rate?</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">As a note, a number of ARVD diagnosed group members have stabilized </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">(i.e. frequent PVCs, short and/or long runs of VT are alleviated) when </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">their Brady pacing is set to 65 - 85 (dependent on patient.)</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">2. If it is known that frequent PVCs often disappear in some people </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">during light exercise, is this the reason that some EPs set their </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">patient's brady pacing as mentioned above?</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">3. Is it well known that patients who go into VT and subsequently pass </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">out often appear to be having a seizure?</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">4. Had the patient in this case been prone to seizures? Do they have </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">epilepsy? Is it possible that a patient suffering that which is </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">described as seizures and syncope, with no evidence of epilepsy, might </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">be suspected of something known to cause VT?</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Thanks in advance for your help with these answers.</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Micheline Tink Long</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">International ARVD Family Network Group</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">--</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr. Sergio Dubner</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President of Scientific Committee</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; "><FONT class="Apple-style-span" face="Arial" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr. Edgardo Schapachnik</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President of Steering Committee</FONT></DIV></BODY></HTML>