Electrocardiographic Features in the Diagnosis and Risk Assessment of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia

Abstract

There are numerous ECG features making the diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia possible such as localised right precordial QRS prolongation, right precordial QRS prolongation, terminal activation delay, S wave upstroke, epsilon waves, QRS fragmentation, reduced amplitude in precordial leads, reduced amplitude ration in right precordial leads and more than complete right bundle branch block. What is new are large Q waves, small R waves and negative T waves in lead aVR and epsilon waves in lead aVR as a risk marker of heart failure. Early repolarisation phenomen appears in 24% of cases, but it is not clear to decide, whether it is a hint of inferior aneurysm or a sign of recurrant ventricular tachycardia. Atrial fibrillation appears either early in the disease progression or very late in intensive form of the disease.