Keywords
Arrhythmogenic cardiomyopathy; Lead aVR; Lead V1; Amplitude of inverted T-waves
Abstract
Background: Arrhythmogenic cardiomyopathy is electrocardiographically characterized by right precordial T-wave inversions and epsilon waves as major criteria. Additionally, terminal activation delay of 55ms or more serves as a minor criterion. More and more evident are pathological data of right ventricles without dilatation or aneurysm, but typical fibrofatty abnormalities and myocardial atrophy. The ECG’s of these patients lack right precordial T-wave inversion and epsilon waves. Lead aVR and lead V1 could become more and more relevant.
Method: 413 cases with arrhythmogenic cardiomyopathy (292 males, mean age 46.3 ± 11.6 years) and a collective of normal probands (1496 patients, 859 males with an age range of 18-81 years) was analyzed with regard to ECG appearance of lead aVR and the amplitude of inverted T-waves in lead V1.
Results: With a specificity of 99.9%, a positive predictive value of 99.7% and a negative predictive value of 98% lead V1 and aVR were most relevant to diagnose arrhythmogenic cardiomyopathy if an amplitude of Q waves of 3mm or more, R waves of 2mm or less, inverted T waves of 2mm or less in lead aVR and inverted T waves in lead V1 were present.
Conclusion: These two leads appear most relevant to make the diagnosis of arrhythmogenic cardiomyopathy even in cases without right ventricular dilatation and right ventricular aneurysms.
Citation
Peters S. Amplitude of Inverted T-Waves in Arrhythmogenic Cardiomyopathy in Special Right Ventricular Leads. SM J Cardiolog and Cardiovasc Disord. 2017; 3(3): 1013s1.