Background The purpose of this study was to systematically study diagnostic a nd prognostic electrocardiographic (ECG) characteristics of arrhythmogenic right ventricle dysplasia/cardiomyopathy (ARVD/C). Methods and Results The patient p opulation included 50 patients with ARVD/C (27 males, 23 females; mean age 38±1 5 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 p atients (22%). T wave inversions in V1 through V3 were observed in 85%of ARVD /C patients in the absence of RBBB compared with none in RVOT and normal control s, respectively(P< 0.0001); epsilon waves were seen in 33%, and a QRS duration ≥110 ms in V1 through V3 was present in 64%of patients. Among those without RB BB, our newly proposed criterion of “prolonged S wave upstroke in V1 throughV3 ”≥55 ms was the most prevalent ECG feature (95%) and correlated with disease severity and induction of VT on electrophysiological study. This feature also b est distinguished ARVD/C (diffuse and localized) from RVOT. Conclusions A prolo nged S wave upstroke in V1 through V3 is the most frequent ECG finding in ARVD/ C and should be considered as a diagnostic ECG marker.
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