Association between abnormal electrocardiographic features and disease severity in patients with arrhythmogenic right ventricular cardiomyopathy
10.3760/cma.j.issn.0253-3758.2011.08.011
- VernacularTitle:心电图评价致心律失常性右心室心肌病病变程度的临床价值
- Author:
Ying-Jie ZHAO
1
;
Yu-He JIA
;
Li-Ke GUAN
;
Wei WEI
;
Jing WANG
;
Ke-Xiu MAO
;
Xu-Hua CHEN
;
Xiao-Yan LIU
;
Shu ZHANG
;
Jian-Min CHU
Author Information
1. 中国医学科学院北京协和医学院阜外心血管病医院
- Keywords:
Arrhythmogenic right ventricular dysplasia;
Electrocardiography;
Magnetic resonance imaging
- From:
Chinese Journal of Cardiology
2011;39(8):734-738
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the relationship between electrocardiographic (ECG) features and disease severity in patients with the arrhythmogenic right ventricular cardiomyopathy (ARVC). Method The study group consisted of 61 subjects with a definite diagnosis of ARVC on the basis of published guideline criteria and patients were divided into 3 subgroups according to the extent of diseased myocardium defined by cardiac magnetic resonance imaging (MRI): Group A: local involvement (n = 19, 31% ), Group B: diffuse involvement of whole right ventricle ( n = 28, 46% ) and Group C: involvement of both right and left ventricles ( n = 14, 23% ). Results Normal electrocardiogram was shown in 1 patient in each group.Epsilon wave was detected in 24 (39%) patients, QRS duration was prolonged [≥ 110 ms( V1 -V3 )] in 21 (34%) patients, S-wave upstroke was prolonged (≥55 ms) in 17 (28%) patients, complete right branch bundle block was evidenced in 10 ( 16% ) patients and pathologic Q waves was found in 9 ( 15% ) patients. The incidence of above abnormal ECG changes was increased in proportion to the degree of disease severity (group A < group B < group C). Incidence of Epsilon wave and prolonged QRS duration [≥ 110 ms (V1 - V3 )] were significantly higher in Group C than in Group A. Incidence of prolonged S-wave upstroke ( ≥55 ms) was significantly higher in Group C than in Group A and Group B. T-wave inversion in V1 leads was often found in Group A. T-wave inversion in inferior leads ( V1 - V3 leads or beyond V3 ) was often presented in Group B and Group C. Conclusions Normal ECG does not exclude the possibility of diagnosis of ARVC. The extent of T-wave inversion in the precordial leads and incidence of Epsilon wave, prolonged QRS duration [≥ 110 ms (Vt -V3 )] and prolonged S-wave upstroke ( ≥55 ms) were related to degree of disease severity in patients with ARVC.