[High-resolution electrocardiography in arrhythmogenic right ventricular disease].
OBJECTIVE
To determine the value of the high-resolution ECG for the differential diagnosis of arrhythmogenic right ventricular disease.


METHODS
A group of 33 patients were studied, 16 males, mean age 34 +/- 16 years. All patients presented non-sustained or sustained or repetitive monomorphic ventricular tachycardias, with left bundle branch block morphology. The anatomic and functional evaluation of the right ventricle was made by a previous echocardiogram. No patient presented left ventricular or septal pathology. High-resolution ECG were obtained from a Corazonix-Predictor II program. In the filtered QRS was analyzed root mean square of the last 40ms QRS, the final lasting of the low amplitude signals < 40 microV and filtered QRS duration. Ten patients underwent to electrophysiological study with right ventricular mapping.


RESULTS
The ventricular tachycardias was non-sustained in 18 patients, sustained in 8 and repetitive monomorphic in 7 patients. The echocardiogram was normal in 23 patients, and all these also presented normal high resolution ECG. Among the 10 patients with altered echocardiogram, 9 presented abnormal high-resolution ECG (sensibility 90%; specificity 100%; positive predictive value 100%; negative predictive value 96%; efficacy of the method to define the presence of manifested right ventricular pathology was 96%). Among the 10 patients with altered echocardiogram, 8 underwent to electrophysiological study. In all was detected an abnormal ventricular mapping and abnormal high-resolution ECG.


CONCLUSIONS
The high-resolution ECG is an useful method to define a right ventricular manifested pathology in presence of arrhythmogenic disease of this cavity.
Maia
I G
IG
Hospital Pró Cardíaco/Pró-Ritmo-Rio de Janeiro.
Cruz Filho
F
F
Fagundes
M L
ML
Costa
A M
AM
Boghossian
S
S
Sá
R
R
Alves
P A
PA
Belem
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000502:physiology
Electrocardiografia de alta resolução na doença ventricular direita arritmogênica.