title: Electrocardiographic (ECG) clues to differentiate idiopathic right ventricular outflow tract tachycardia (RVOTT) from arrhythmogenic right ventricular cardiomyopathy (ARVC).
abstract: BACKGROUND
  Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a genetic cardiomyopathy that most commonly affects young adults. The most commonly observed reason of death in patients suffering from ARVC/D is sudden cardiac death (SCD). On the other hand, idiopathic right ventricular outflow tract tachycardia (RVOT VT) usually has a benign course. Both of the entities may have ventricular tachycardia (VT) with left bundle branch block (LBBB) pattern and inferior axis. We tried to propose new discriminating electrocardiographic indices for differentiation of foretold entities.
  
  
  METHODS
  This was a retrospective study. We reviewed records of patients admitted between 2003 and 2012 with the diagnosis of either ARVC/D or RVOT VT that presented with VT (LBBB morphology).
  
  
  RESULTS
  A total of fifty nine patients (30 RVOT VT and 29 ARVC/D) were enrolled. In ARVC/D group, men were dominant while the reverse was true of RVOT VT. Palpitation was more common in the RVOT VT group (90% vs. 66.7%), but aborted SCD and sustained VT were more common in ARVC/D group. The new ECG criteria proposed by us mean QRS duration in V1-V3, QRS difference in right and left precordial leads, S wave upstroke duration, JT interval dispersion, QRS and JT interval of right to left precordial leads were all significantly longer in ARVC/D when compared to RVOT VT patients (p < 0.001).
  
  
  CONCLUSIONS
  The proposed ECG criteria can be used for non-invasive diagnosis of ARVC/D and incorporation in the future updates of ARVC/D task force criteria.
authors: Associate Professor, Cardiac Electrophysiology Department, Shahid Rajaee Heart Center, Iran University of Medical Sciences, Iran.
authors: Zahra
authors: Z
authors: Emkanjoo
authors: Assistant Professor, Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran. Electronic address: mollazar@yahoo.com.
authors: Reza
authors: R
authors: Mollazdeh
authors: Associate Professor, Cardiac Electrophysiology Department, Shahid Rajaee Heart Center, Iran University of Medical Sciences, Iran.
authors: Abolfath
authors: A
authors: Alizadeh
authors: Assistant Professor, Cardiac Electrophysiology Department, Shahid Rajaee Heart Center, Iran University of Medical Sciences, Iran.
authors: Jalal
authors: J
authors: Kheirkhah
authors: General Cardiologist, Cardiology Department, Shahid Chamran Hospital, Isfahan University of Medical Sciences, Iran.
authors: Zarrin
authors: Z
authors: Mohammadi
authors: Assistant Professor, Cardiology Department, Shahid Chamran Hospital, Isfahan University of Medical Sciences, Iran.
authors: Mazdak
authors: M
authors: Khalili
authors: Assistant Professor, Cardiology Department, Shahid Chamran Hospital, Isfahan University of Medical Sciences, Iran.
authors: Amirhossein
authors: A
authors: Azhari
authors: Assistant Professor, Cardiac Electrophysiology Department, Shahid Rajaee Heart Center, Iran University of Medical Sciences, Iran.
authors: Sorayya
authors: S
authors: Shahrzad
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000503:physiopathology
keywords: Arrhythmogenic right ventricular cardiomyopathy; Outflow tract; Ventricular tachycardia
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