title: [Association between abnormal electrocardiographic features and disease severity in patients with arrhythmogenic right ventricular cardiomyopathy].
abstract: OBJECTIVE
  To analyze the relationship between electrocardiographic (ECG) features and disease severity in patients with the arrhythmogenic right ventricular cardiomyopathy (ARVC).
  
  
  METHODS
  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 (V(1)-V(3))] 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 (V(1)-V(3))] 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 V(1) leads was often found in Group A. T-wave inversion in inferior leads (V(1)-V(3) leads or beyond V(3)) 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 (V(1)-V(3))] and prolonged S-wave upstroke (≥ 55 ms) were related to degree of disease severity in patients with ARVC.
authors.affiliation: Cardiac Arrhythmia Center, Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China.
authors.forename: Ying-jie
authors.initials: YJ
authors.lastname: Zhao
authors.forename: Yu-he
authors.initials: YH
authors.lastname: Jia
authors.forename: Li-ke
authors.initials: LK
authors.lastname: Guan
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Ke-xiu
authors.initials: KX
authors.lastname: Mao
authors.forename: Xu-hua
authors.initials: XH
authors.lastname: Chen
authors.forename: Xiao-yan
authors.initials: XY
authors.lastname: Liu
authors.forename: Shu
authors.initials: S
authors.lastname: Zhang
authors.forename: Jian-min
authors.initials: JM
authors.lastname: Chu
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000473:pathology / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult