title: T-wave integral: an electrocardiographic marker discriminating patients with arrhythmogenic right ventricular cardiomyopathy from patients with right ventricular outflow tract tachycardia.
abstract: OBJECTIVE
  Clinical and electrocardiographic (ECG) presentation of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and idiopathic right ventricular outflow-tract tachycardia (RVOT) may be similar. The aim of the study was to assess the validity and utility of T-wave integral measurement as an ECG discriminator of patients with ARVC and RVOT using a body surface mapping (BSM).
  
  
  RESULTS
  A 120-channel BSM with quantitative signal analysis of the T-wave integral was performed in 10 patients with ARVC. Results were compared with those obtained from 13 patients with RVOT and a control group of 12 healthy subjects (controls). Age, body mass index, and QRS-axis on surface ECG were not significantly different between the groups. Arrhythmogenic right ventricular cardiomyopathy patients showed a significantly negative T-wave integral in the right lower anterior region of the torso when compared with RVOT (P < 0.001). There was no statistically significant difference between RVOT patients and controls. At a cut-off level of -0.3 mV ms, sensitivity and specificity were 83% [area under curve (AUC) 0.85 ± 0.04 for the comparison of ARVC and RVOT]. These differences were pronounced in ARVC patients with a plakophlin-2 mutation (P < 0.001).
  
  
  CONCLUSIONS
  Quantitative analysis of the BSM T-wave integral in distinct anatomical regions discriminates ARVC patients from RVOT patients and controls and may serve as an additional diagnostic tool.
authors.affiliation: Department of Cardiovascular Medicine, Division of Cardiology, University Hospital Münster, Münster, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Samol
authors.forename: Christian
authors.initials: C
authors.lastname: Wollmann
authors.forename: Christian
authors.initials: C
authors.lastname: Vahlhaus
authors.forename: Joachim
authors.initials: J
authors.lastname: Gerss
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Bruns
authors.forename: Günter
authors.initials: G
authors.lastname: Breithardt
authors.forename: Eric
authors.initials: E
authors.lastname: Schulze-Bahr
authors.forename: Thomas
authors.initials: T
authors.lastname: Wichter
authors.forename: Matthias
authors.initials: M
authors.lastname: Paul
mesh_terms: D000328:Adult; D000368:Aged; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D018780:Body Surface Potential Mapping; D016022:Case-Control Studies; D004252:DNA Mutational Analysis; D003937:Diagnosis, Differential; D005260:Female; D020022:Genetic Predisposition to Disease; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010641:Phenotype; D051191:Plakophilins / Q000235:genetics; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: C495337:PKP2 protein, human; D051191:Plakophilins