title: Usefulness of T(peak) -T(end) interval to distinguish arrhythmogenic right ventricular cardiomyopathy from idiopathic right ventricular outflow tract tachycardia.
abstract: BACKGROUND
  The two predominant etiologies of right ventricular tachycardia (VT) are arrhythmogenic right ventricular cardiomyopathy (ARVC) and idiopathic VT arising from the right ventricular outflow tract (RVOT). Discrimination between these two entities is critical, as their prognoses and therapeutic options differ. The Tpeak -Tend (Tpe) interval reflects the transmural repolarization dispersion and its prolongation is associated with high mortality.
  
  
  METHODS
  We compared the sinus rhythm electrocardiogram (ECG) of 43 patients (24 male, 43 ± 16 years) with VT originating from right ventricle. Five patients under antiarrhythmic drug therapy were excluded. Tpe interval was measured in each precordial leads and compared among patients with ARVC and RVOT-VT.
  
  
  RESULTS
  Twenty-five patients (16 male, 42 ± 16 years) met the Task Force criteria for the diagnosis of ARVC, and 13 patients (seven male, 45 ± 14 years) had idiopathic RVOT tachycardia. Patients with ARVC had significantly prolonged Tpe intervals in all precordial leads compared to patients with idiopathic RVOT VT (137.1 ± 32.6 ms vs 93.8 ± 16.9 ms; P < 0.001 in V1, 133.2 ± 35.5 ms vs 104.7 ± 16.9 ms; P = 0.01 in V2, 125.7 ± 31.5 ms vs 99.1 ± 19.6 ms; P = 0.09 in V3, 121.9 ± 26.5 ms vs 92.3 ± 19.7 ms; P = 0.001 in V4, 123.1 ± 26.5 ms vs 99.5 ± 20:1 ms; P = 0.04 in V5 and 126.9 ± 32.2 ms vs 89 ± 11.3 ms; P < 0.001 in V6, respectively). For the diagnosis of ARVC, Tpe cut-off value of 97 ms in V1 had 84% sensitivity and 62% specificity (area under curve = 0.880).
  
  
  CONCLUSIONS
  In patients with VT of RV origin, the prolonged Tpe interval in sinus rhythm electrocardiogram supports the diagnosis of ARVC.
authors.affiliation: Department of Cardiology, Kocaeli Derince Research and Training Hospital, Kocaeli, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Golcuk
authors.forename: Kivanc
authors.initials: K
authors.lastname: Yalin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kaya Bilge
authors.forename: Ali
authors.initials: A
authors.lastname: Elitok
authors.forename: Tolga
authors.initials: T
authors.lastname: Aksu
authors.forename: Taylan
authors.initials: T
authors.lastname: Akgun
authors.forename: Ekrem
authors.initials: E
authors.lastname: Bilal Karaayvaz
authors.forename: Samim
authors.initials: S
authors.lastname: Emet
authors.forename: Kamil
authors.initials: K
authors.lastname: Adalet
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000175:diagnosis*
keywords: arrhythmogenic right ventricular cardiomyopathy; electrocardiography; ventricular outflow tract tachycardia; ventricular tachycardia