Electrocardiographic features of arrhythmogenic right ventricular dysplasia/cardiomyopathy according to disease severity: A need to broaden diagnostic criteria

Khurram Nasir, Chandra Bomma, Harikrishna Tandri, Ariel Roguin, Darshan Dalal, Kalpana Prakasa, Crystal Tichnell, Cynthia James, Phillip Jspevak, Frank Marcus, Hugh Calkins

Research output: Contribution to journalArticle

Abstract

Background - The purpose of this study was to systematically study diagnostic and prognostic electrocardiographic (ECG) characteristics of arrhythmogenic right ventricle dysplasia/cardiomyopathy (ARVD/C). Methods and Results - The patient population included 50 patients with ARVD/C (27 males, 23 females; mean age 38±15 years). We also analyzed the ECG of 50 age- and gender-matched normal control subject and 28 consecutive patients who presented with right ventricular outflow tract (RVOT) tachycardia. Right bundle-branch block (RBBB) was present in 11 patients (22%). T-wave inversions in V 1 through V3 were observed in 85% of ARVD/C patients in the absence of RBBB compared with none in RVOT and normal controls, respectively (P1 through V3 was present in 64% of patients. Among those without RBBB, our newly proposed criterion of "prolonged S-wave upstroke in V1 through V3" ≥55 ms was the most prevalent ECG feature (95%) and correlated with disease severity and induction of VT on electrophysiological study. This feature also best distinguished ARVD/C (diffuse and localized) from RVOT. Conclusions - A prolonged S-wave upstroke in V 1 through V3 is the most frequent ECG finding in ARVD/C and should be considered as a diagnostic ECG marker.

Original languageEnglish (US)
Pages (from-to)1527-1534
Number of pages8
JournalCirculation
Volume110
Issue number12
DOIs
StatePublished - Sep 21 2004

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Arrhythmogenic Right Ventricular Dysplasia
Cardiomyopathies
Heart Ventricles
Bundle-Branch Block
Tachycardia
Population

Keywords

  • Cardiomyopathy
  • Diagnosis
  • Electrocardiography

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Electrocardiographic features of arrhythmogenic right ventricular dysplasia/cardiomyopathy according to disease severity : A need to broaden diagnostic criteria. / Nasir, Khurram; Bomma, Chandra; Tandri, Harikrishna; Roguin, Ariel; Dalal, Darshan; Prakasa, Kalpana; Tichnell, Crystal; James, Cynthia; Jspevak, Phillip; Marcus, Frank; Calkins, Hugh.

In: Circulation, Vol. 110, No. 12, 21.09.2004, p. 1527-1534.

Research output: Contribution to journalArticle

Nasir, Khurram ; Bomma, Chandra ; Tandri, Harikrishna ; Roguin, Ariel ; Dalal, Darshan ; Prakasa, Kalpana ; Tichnell, Crystal ; James, Cynthia ; Jspevak, Phillip ; Marcus, Frank ; Calkins, Hugh. / Electrocardiographic features of arrhythmogenic right ventricular dysplasia/cardiomyopathy according to disease severity : A need to broaden diagnostic criteria. In: Circulation. 2004 ; Vol. 110, No. 12. pp. 1527-1534.
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