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Electrocardiographic features of arrhythmogenic right ventricular dysplasia.

Publication ,  Journal Article
Jain, R; Dalal, D; Daly, A; Tichnell, C; James, C; Evenson, A; Jain, R; Abraham, T; Tan, BY; Tandri, H; Russell, SD; Judge, D; Calkins, H
Published in: Circulation
August 11, 2009

BACKGROUND: The purpose of this study was to reevaluate the ECG features of arrhythmogenic right ventricular dysplasia (ARVD). The second objective was to evaluate the sensitivity and specificity of the standard and newly proposed diagnostic ECG markers in the presence of a right bundle-branch block (RBBB). METHODS AND RESULTS: One hundred patients with ARVD (57 men; aged 39+/-15 years) and 57 controls (21 men; aged 40+/-17 years) were included. Among the 100 patients with ARVD, a complete RBBB was present in 17 patients, and 15 patients had an incomplete RBBB. T-wave inversion through V(3) demonstrated optimal sensitivity and specificity in both ARVD patients without a complete RBBB or incomplete RBBB (71% [95% confidence interval, 58% to 81%] and 96% [95% confidence interval, 81% to 100%], respectively) and in ARVD patients with incomplete RBBB (73% [95% confidence interval, 45% to 92%] and 95% [95% confidence interval, 77% to 100%], respectively). Between ARVD patients and controls with a complete RBBB, the only 2 parameters that differed were the prevalence of T-wave inversion through V(4) (59% versus 12%, respectively; P<0.05) and an r'/s ratio in V(1) <1 (88% versus 14%, respectively; P<0.005). In ARVD patients with complete RBBB, the most sensitive and specific parameter was an r'/s ratio <1. CONCLUSIONS: We evaluated comprehensively the diagnostic value of ECG markers for ARVD. On the basis of the findings, we propose an algorithm, with examination of QRS morphology being the first step, for ECG evaluation of ARVD patients. Definite criteria are then applied on the basis of the presence of no RBBB, incomplete RBBB, and complete RBBB to obtain the best diagnostic utility of the ECG.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

August 11, 2009

Volume

120

Issue

6

Start / End Page

477 / 487

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Reproducibility of Results
  • Reference Standards
  • Prevalence
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electrocardiography
  • Cardiovascular System & Hematology
 

Citation

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Jain, R., Dalal, D., Daly, A., Tichnell, C., James, C., Evenson, A., … Calkins, H. (2009). Electrocardiographic features of arrhythmogenic right ventricular dysplasia. Circulation, 120(6), 477–487. https://doi.org/10.1161/CIRCULATIONAHA.108.838821
Jain, Rahul, Darshan Dalal, Amy Daly, Crystal Tichnell, Cynthia James, Ariana Evenson, Rohit Jain, et al. “Electrocardiographic features of arrhythmogenic right ventricular dysplasia.Circulation 120, no. 6 (August 11, 2009): 477–87. https://doi.org/10.1161/CIRCULATIONAHA.108.838821.
Jain R, Dalal D, Daly A, Tichnell C, James C, Evenson A, et al. Electrocardiographic features of arrhythmogenic right ventricular dysplasia. Circulation. 2009 Aug 11;120(6):477–87.
Jain, Rahul, et al. “Electrocardiographic features of arrhythmogenic right ventricular dysplasia.Circulation, vol. 120, no. 6, Aug. 2009, pp. 477–87. Pubmed, doi:10.1161/CIRCULATIONAHA.108.838821.
Jain R, Dalal D, Daly A, Tichnell C, James C, Evenson A, Abraham T, Tan BY, Tandri H, Russell SD, Judge D, Calkins H. Electrocardiographic features of arrhythmogenic right ventricular dysplasia. Circulation. 2009 Aug 11;120(6):477–487.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

August 11, 2009

Volume

120

Issue

6

Start / End Page

477 / 487

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Reproducibility of Results
  • Reference Standards
  • Prevalence
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electrocardiography
  • Cardiovascular System & Hematology