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Changes in Follow‐Up ECG and Signal‐Averaged ECG in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy
Author(s) -
BAE MYUNG HWAN,
KIM JAE HEE,
JANG SE YONG,
PARK SUN HEE,
LEE JANG HOON,
YANG DONG HEON,
PARK HUN SIK,
CHO YONGKEUN,
CHAE SHUNG CHULL
Publication year - 2014
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12285
Subject(s) - medicine , signal averaged electrocardiogram , cardiology , qrs complex , t wave , cardiomyopathy , electrocardiography , heart failure
Background Electrocardiogram (ECG) and signal‐averaged ECG (SAECG) are important as diagnostic tools in arrhythmogenic right ventricular cardiomyopathy (ARVC). The aim of this study was to investigate changes in follow‐up ECGs and SAECGs in patients with ARVC. Methods We collected 185 follow‐up ECGs from 38 patients and 35 follow‐up SAECGs from 18 patients during a mean follow‐up period of 64 ± 36 months. Results On baseline ECG and SAECG, epsilon waves, T‐wave inversion (TWI), and terminal activation delay (TAD) of QRS ≥55 ms in right precordial leads, and late potentials (LPs) were observed in six (16%), 11 (29%), 13 (34%), and 23 (68%) patients, respectively. During the follow‐up period, 15 (39%) patients had 18 changes in ECG and/or SAECG features included in modified Task Force Criteria (TFC) of ARVC. Two patients developed new epsilon waves, and another two patients had dynamic epsilon waves. Newly developed TAD of QRS ≥55 ms was observed in two patients and disappeared in one patient. Eight patients, seven with and one without TWI in V 1 –V 3 or beyond, showed dynamic changes. LP developed in three patients. One patient with dynamic change of TWI and another patient with dynamic change of epsilon wave and TAD of QRS ≥55 ms could not satisfy the modified TFC during follow‐up. Conclusions Follow‐up ECGs and SAECGs showed changes in 39% of patients with ARVC. Larger studies with a longer follow‐up period are needed to investigate the clinical implications of changes in follow‐up ECG and SAECG.