title: Electrocardiographic features of disease progression in arrhythmogenic right ventricular cardiomyopathy/dysplasia.
abstract: BACKGROUND
  Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is considered a progressive cardiomyopathy. However, data on the clinical features of disease progression are limited. The aim of this study was to assess 12-lead surface electrocardiographic (ECG) changes during long-term follow-up, and to compare these findings with echocardiographic data in our large cohort of patients with ARVC/D.
  
  
  METHODS
  Baseline and follow-up ECGs of 111 patients from three tertiary care centers in Switzerland were systematically analyzed with digital calipers by two blinded observers, and correlated with findings from transthoracic echocardiography.
  
  
  RESULTS
  The median follow-up was 4 years (IQR 1.9-9.2 years). ECG progression was significant for epsilon waves (baseline 14% vs. follow-up 31%, p = 0.01) and QRS duration (111 ms vs. 114 ms, p = 0.04). Six patients with repolarization abnormalities according to the 2010 Task Force Criteria at baseline did not display these criteria at follow-up, whereas in all patients with epsilon waves at baseline these depolarization abnormalities also remained at follow-up. T wave inversions in inferior leads were common (36% of patients at baseline), and were significantly associated with major repolarization abnormalities (p = 0.02), extensive echocardiographic right ventricular involvement (p = 0.04), T wave inversions in lateral precordial leads (p = 0.05), and definite ARVC/D (p = 0.05).
  
  
  CONCLUSIONS
  Our data supports the concept that ARVC/D is generally progressive, which can be detected by 12-lead surface ECG. Repolarization abnormalities may disappear during the course of the disease. Furthermore, the presence of T wave inversions in inferior leads is common in ARVC/D.
authors.forename: Ardan M
authors.initials: AM
authors.lastname: Saguner
authors.forename: Sabrina
authors.initials: S
authors.lastname: Ganahl
authors.forename: Andrea
authors.initials: A
authors.lastname: Kraus
authors.forename: Samuel H
authors.initials: SH
authors.lastname: Baldinger
authors.forename: Deniz
authors.initials: D
authors.lastname: Akdis
authors.forename: Arhan R
authors.initials: AR
authors.lastname: Saguner
authors.forename: Thomas
authors.initials: T
authors.lastname: Wolber
authors.forename: Laurent M
authors.initials: LM
authors.lastname: Haegeli
authors.forename: Jan
authors.initials: J
authors.lastname: Steffel
authors.forename: Nazmi
authors.initials: N
authors.lastname: Krasniqi
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Felix C
authors.initials: FC
authors.lastname: Tanner
authors.forename: Corinna
authors.initials: C
authors.lastname: Brunckhorst
authors.affiliation: Department of Cardiology, University Heart Center Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland. firat.duru@usz.ch.
authors.forename: Firat
authors.initials: F
authors.lastname: Duru
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018450:Disease Progression; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult