Arrhythmogenic right ventricular dysplasia ECG

Arrhythmogenic right ventricular dysplasia Microchapters
Home
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Arrhythmogenic right ventricular dysplasia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
X - Ray
ECG
Cardiac MRI
Echocardiogram
Other Imaging Findings
Endomyocardial biopsy
Atuopsy
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
Arrhythmogenic right ventricular dysplasia ECG On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Arrhythmogenic right ventricular dysplasia ECG All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
National Guidelines Clearinghouse
NICE Guidance
FDA on Arrhythmogenic right ventricular dysplasia ECG
CDC on Arrhythmogenic right ventricular dysplasia ECG
Arrhythmogenic right ventricular dysplasia ECG in the news
Blogs onArrhythmogenic right ventricular dysplasia ECG
Directions to Hospitals Treating Arrhythmogenic right ventricular dysplasia
Risk calculators and risk factors for Arrhythmogenic right ventricular dysplasia ECG

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

In order to make the diagnosis of ARVD, a number of clinical tests are employed, including the electrocardiogram (EKG), echocardiography, right ventricular angiography, and cardiac MRI.

ECG Findings

90% of individuals with ARVD have some EKG abnormality. The most common EKG abnormality seen in ARVD is T wave inversion in leads V₁ to V₃. However, this is a non-specific finding, and may be considered a normal variant in right bundle branch block (RBBB), women, and children under 12 years old.

RBBB itself is seen frequently in individuals with ARVD. This may be due to delayed activation of the right ventricle, rather than any intrinsic abnormality in the right bundle branch.

EKG lead demonstrating the epsilon wave The epsilon wave

The epsilon wave (red triangle), seen in ARVD.

The epsilon wave is found in about 50% of those with ARVD. This is described as a terminal notch in the QRS complex. It is due to slowed intraventricular conduction. The epsilon wave may be seen on a surface EKG; however, it is more commonly seen on signal averaged EKGs.

Ventricular ectopy seen on a surface EKG in the setting of ARVD is typically of left bundle branch block (LBBB) morphology, with a QRS axis of -90 to +110 degrees. The origin of the ectopic beats is usually from one of the three regions of fatty degeneration (the "triangle of dysplasia"): the RV outflow tract, the RV inflow tract, and the RV apex.

Signal averaged ECG

Signal averaged ECG (SAECG) is used to detect late potentials and epsilon waves in individuals with ARVD.