Zahra Emkanjoo1, Reza Mollazdeh2, Abolfath Alizadeh1, Jalal Kheirkhah3, Zarrin Mohammadi4, Mazdak Khalili5, Amirhossein Azhari5, Sorayya Shahrzad3. 1. Associate Professor, Cardiac Electrophysiology Department, Shahid Rajaee Heart Center, Iran University of Medical Sciences, Iran. 2. Assistant Professor, Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran. Electronic address: mollazar@yahoo.com. 3. Assistant Professor, Cardiac Electrophysiology Department, Shahid Rajaee Heart Center, Iran University of Medical Sciences, Iran. 4. General Cardiologist, Cardiology Department, Shahid Chamran Hospital, Isfahan University of Medical Sciences, Iran. 5. Assistant Professor, Cardiology Department, Shahid Chamran Hospital, Isfahan University of Medical Sciences, Iran.
Abstract
INTRODUCTION: 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. MATERIAL AND METHOD: 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). RESULT: 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). CONCLUSION: 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.
INTRODUCTION: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. MATERIAL AND METHOD: 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). RESULT: 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 VTpatients (p < 0.001). CONCLUSION: 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: Daniel P Morin; Andreas C Mauer; Kathleen Gear; Wojciech Zareba; Steven M Markowitz; Frank I Marcus; Bruce B Lerman Journal: Am J Cardiol Date: 2010-04-27 Impact factor: 2.778
Authors: F Niroomand; C Carbucicchio; C Tondo; S Riva; G Fassini; A Apostolo; N Trevisi; P Della Bella Journal: Heart Date: 2002-01 Impact factor: 5.994
Authors: Sei Iwai; Daniel J Cantillon; Robert J Kim; Steven M Markowitz; Suneet Mittal; Kenneth M Stein; Bindi K Shah; Ravi K Yarlagadda; Jim W Cheung; Vivian R Tan; Bruce B Lerman Journal: J Cardiovasc Electrophysiol Date: 2006-06-27
Authors: Craig D Ainsworth; Allan C Skanes; George J Klein; Lorne J Gula; Raymond Yee; Andrew D Krahn Journal: Heart Rhythm Date: 2006-04 Impact factor: 6.343
Authors: A Nava; B Bauce; C Basso; M Muriago; A Rampazzo; C Villanova; L Daliento; G Buja; D Corrado; G A Danieli; G Thiene Journal: J Am Coll Cardiol Date: 2000-12 Impact factor: 24.094