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The S-wave angle identifies arrhythmogenic right ventricular cardiomyopathy in patients with electrocardiographically

Daniel Cortez1, Anneli Svensson2, Jonas Carlson3

  • 1Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden; Electrophysiology/Cardiology, Penn State Milton S. Hershey Medical Center, Hershey, USA; Department of pediatric cardiology, University of Minnesota/Masonic Children's Hospital, Minneapolis, USA.

Journal of Electrocardiology
|December 1, 2018
PubMed

Insights

The S-wave angle can identify arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) in patients with normal electrocardiograms (ECG). This finding may help detect ARVD/C earlier, even before standard ECG criteria are met.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a significant cause of sudden cardiac death.
  • Early detection of ARVD/C is crucial for risk stratification and management.
  • Subtle electrocardiogram (ECG) abnormalities may precede overt diagnostic criteria.

Purpose of the Study:

  • To investigate the utility of the S-wave angle in differentiating ARVD/C patients with normal ECGs from healthy controls.
  • To determine if the S-wave angle can serve as an early marker for ARVD/C.

Main Methods:

  • A comparative study involving ARVD/C patients meeting Task Force 2010 criteria and age/sex-matched controls.
  • Electrocardiogram (ECG) parameters, including QRS duration, corrected QT interval, and S-wave angle in lead V2, were assessed.
  • Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of the S-wave angle.

Main Results:

  • The S-wave angle significantly differentiated ARVD/C patients with normal ECGs from controls (p < 0.001).
  • The S-wave angle demonstrated good diagnostic accuracy with an area under the ROC curve of 0.77.
  • An elevated S-wave angle was strongly associated with ARVD/C (Odds Ratio = 28.3).

Conclusions:

  • The S-wave angle is a valuable tool for identifying subtle ECG abnormalities in ARVD/C.
  • This measurement may aid in the early diagnosis of ARVD/C, potentially before the development of established Task Force ECG criteria.
  • The S-wave angle could improve risk stratification in patients with suspected ARVD/C.
Abstract

Keywords:
Arrhythmogenic right ventricular cardiomyopathyCascade screeningECGS-wave angle

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