Electrovectorcardiographic study of negative T waves on precordial leads in arrhythmogenic right ventricular dysplasia: Relationship with right ventricular volumes

Nava, Andrea; Canciani, B; Buja, Gianfranco; Martini, Bortolo; Daliento, Luciano; Scognamiglio, R; Thiene, Gaetano

doi:10.1016/0022-0736(88)90098-2

Cited by 74 publications

(26 citation statements)

References 14 publications

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“…5,6 T-wave inversion in leads V 1 through V 3 in the absence of RBBB is considered a minor diagnostic criterion for ARVD/C, 5 and its prevalence in ARVD/C has been reported as 55% to 94% in different series. 2,6,9 The extent of right precordial T-wave inversion relates to the degree of RV involvement, as reported by Nava et al 8 Despite the frequent association of T-wave inversion with ARVD/C, it is not specific for ARVD/C, particularly because it may be a normal finding in children less than 12 years of age and can also be seen in normal individuals.…”

Section: Discussionmentioning

confidence: 77%

Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity

et al. 2004

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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 38Ϯ15 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 V 3 were observed in 85% of ARVD/C patients in the absence of RBBB compared with none in RVOT and normal controls, respectively (PϽ0.0001); epsilon waves were seen in 33%, and a QRS duration Ն110 ms in V 1 through V 3 was present in 64% of patients. Among those without RBBB, our newly proposed criterion of "prolonged S-wave upstroke in V 1 through V 3" Ն55 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 V 3 is the most frequent ECG finding in ARVD/C and should be considered as a diagnostic ECG marker.

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Section: Discussionmentioning

confidence: 77%

Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity

et al. 2004

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“…26 However, in a recent study of newly diagnosed patients with suspected ARVC, inverted T waves limited to V 1 to V 3 were present in only 16% of the subjects, and 32% of the subjects had right precordial T-wave inversions extending beyond V 3 . 10 Abnormalities in repolarization and depolarization observed in a standard 12-lead ECG play a pivotal role in the diagnosis of ARVC.…”

Section: Discussionmentioning

confidence: 91%

Prevalence and Prognostic Significance of T-Wave Inversions in Right Precordial Leads of a 12-Lead Electrocardiogram in the Middle-Aged Subjects

A¹,

Anttonen²,

Tikkanen³

et al. 2012

Circulation

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Background-T-wave inversion in right precordial leads V 1 to V 3 is a relatively common finding in a 12-lead ECG of children and adolescents and is infrequently found also in healthy adults. However, this ECG pattern can also be the first presentation of arrhythmogenic right ventricular cardiomyopathy. The prevalence and prognostic significance of T-wave inversions in the middle-aged general population are not well known. Methods and Results-We evaluated 12-lead ECGs of 10 899 Finnish middle-aged subjects (52% men, mean age 44Ϯ8.5 years) recorded between 1966 and 1972 for the presence of inverted T waves and followed the subjects for 30Ϯ11 years.Primary end points were all-cause mortality, cardiac mortality, and arrhythmic death. T-wave inversions in right precordial leads V 1 to V 3 were present in 54 (0.5%) of the subjects. In addition, 76 (0.7%) of the subjects had inverted T waves present only in leads other than V 1 to V 3 . Right precordial T-wave inversions did not predict increased mortality (not significant for all end points). However, inverted T waves in leads other than V 1 to V 3 were associated with an increased risk of cardiac and arrhythmic death (PϽ0.001 for both). Conclusions-T-wave inversions in right precordial leads are relatively rare in the general population, and are not associated with adverse outcome. Increased mortality risk associated with inverted T waves in other leads may reflect the presence of an underlying structural heart disease. (Circulation. 2012;125:2572-2577.)

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“…The 12-lead ECG was manifestly abnormal with TWI in leads V1-V5 and localized right precordial QRS prolongation. The extent of the precordial TWI provides an indication of the extent of RV involvement and/or enlargement [19,22]. It has been suggested that patients with TWI in V1-V4 may have a more advanced stage of the disease [19].…”

Section: Casementioning

confidence: 99%

Signs of RV overload on the athlete’s ECG

Claessen

Brosnan

Gerche

et al. 2015

Journal of Electrocardiology

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There is increasing evidence that regular intense endurance exercise can promote structural and electrical remodeling of the right ventricle (RV). These physiological changes can be profound and are frequently accompanied by ECG changes in the right precordial leads, thereby mimicking features observed in arrhythmogenic right ventricular cardiomyopathy (ARVC). Because the 12-lead ECG is used as both a screening and diagnostic tool for the detection of conditions associated with sudden death in athletes, it is of fundamental importance to have a good understanding of the ECG features that distinguish physiological adaptations to endurance exercise from those related to RV pathology as well as their potential overlap. This article describes ECG findings observed in healthy endurance athletes versus athletes with underlying RV pathology and illustrates their differentiation using 4 case presentations.

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Electrovectorcardiographic study of negative T waves on precordial leads in arrhythmogenic right ventricular dysplasia: Relationship with right ventricular volumes

Cited by 74 publications

References 14 publications

Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity

Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity

Prevalence and Prognostic Significance of T-Wave Inversions in Right Precordial Leads of a 12-Lead Electrocardiogram in the Middle-Aged Subjects

Signs of RV overload on the athlete’s ECG

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