CONTEXT: QRS fragmentation, including epsilon potentials, terminal activation delay and prolonged S wave upstroke, has been recently described as a diagnostic criterion of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). Whether QRS fragmentation is a marker of recurrent ventricular tachycardia, primary ventricular fibrillation, implantable cardioverter defibrillator (ICD) discharge and sudden cardiac death in these patients is unknown. RESULTS: Three hundred and thirty-five patients (167 men, mean age 46.3 ± 14.6 years) with ARVC/D according to International Society and Federation of Cardiology/European Society of Cardiology (ISFC/ESC) criteria were analyzed retrospectively. Patients with complete and incomplete right bundle branch block were excluded from the analysis. At 6.3 ± 3.1 years mean follow-up, seven patients (0.02%) had died suddenly, 39 patients (0.13%) experienced recurrent ventricular tachycardia, 32 patients (0.1%) presented with primary ventricular fibrillation and 30 patients (0.1%) had recurrent ICD discharges. QRS fragmentation was significantly associated with arrhythmic events (P < 0.0000001 for the endpoint of sudden cardiac death, P < 0.01 for recurrent ventricular tachycardia, P < 0.0001 for primary ventricular fibrillation and P < 0.001 for recurrent ICD discharges, respectively). CONCLUSION: QRS fragmentation predicts arrhythmic events in patients with ARVC/D. Further, properly designed prospective studies are warranted to confirm these findings.
CONTEXT: QRS fragmentation, including epsilon potentials, terminal activation delay and prolonged S wave upstroke, has been recently described as a diagnostic criterion of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). Whether QRS fragmentation is a marker of recurrent ventricular tachycardia, primary ventricular fibrillation, implantable cardioverter defibrillator (ICD) discharge and sudden cardiac death in these patients is unknown. RESULTS: Three hundred and thirty-five patients (167 men, mean age 46.3 ± 14.6 years) with ARVC/D according to International Society and Federation of Cardiology/European Society of Cardiology (ISFC/ESC) criteria were analyzed retrospectively. Patients with complete and incomplete right bundle branch block were excluded from the analysis. At 6.3 ± 3.1 years mean follow-up, seven patients (0.02%) had died suddenly, 39 patients (0.13%) experienced recurrent ventricular tachycardia, 32 patients (0.1%) presented with primary ventricular fibrillation and 30 patients (0.1%) had recurrent ICD discharges. QRS fragmentation was significantly associated with arrhythmic events (P < 0.0000001 for the endpoint of sudden cardiac death, P < 0.01 for recurrent ventricular tachycardia, P < 0.0001 for primary ventricular fibrillation and P < 0.001 for recurrent ICD discharges, respectively). CONCLUSION: QRS fragmentation predicts arrhythmic events in patients with ARVC/D. Further, properly designed prospective studies are warranted to confirm these findings.
Authors: Francisco Femenía; Maurico Arce; Jorge Van Grieken; Emilce Trucco; Luis Mont; Mauricio Abello; José L Merino; Máximo Rivero-Ayerza; Bulent Gorenek; Carlos Rodriguez; Wilma M Hopman; Adrian Baranchuk Journal: J Interv Card Electrophysiol Date: 2013-09-08 Impact factor: 1.900
Authors: Adrian Baranchuk; Francisco Femenia; Juan Cruz López-Diez; Claudio Muratore; Mariana Valentino; Enrique Retyk; Nestor Galizio; Darío Di Toro; Karina Alonso; Wilma M Hopman; Rodrigo Miranda Journal: Ann Noninvasive Electrocardiol Date: 2013-09-09 Impact factor: 1.468
Authors: Laurens P Bosman; Julia Cadrin-Tourigny; Mimount Bourfiss; Mounes Aliyari Ghasabeh; Apurva Sharma; Crystal Tichnell; Rob W Roudijk; Brittney Murray; Harikrishna Tandri; Paul Khairy; Ihab R Kamel; Stefan L Zimmerman; Johannes B Reitsma; Folkert W Asselbergs; J Peter van Tintelen; Jeroen F van der Heijden; Richard N W Hauer; Hugh Calkins; Cynthia A James; Anneline S J M Te Riele Journal: Europace Date: 2020-05-01 Impact factor: 5.214