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Correlation between Epsilon Wave and Late Potentials in Arrhythmogenic Right Ventricular Cardiomyopathy-Do Late
Urszula Skrzypczyńska-Banasik1, Olgierd Woźniak1, Ilona Kowalik1
1Cardinal Wyszynski National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland.
Journal of Clinical Medicine
|September 14, 2024
Summary
Arrhythmogenic right ventricular cardiomyopathy (ARVC) patients show a strong link between epsilon waves (EW) and late ventricular potentials (LPs). This suggests a common cause related to fibrofatty changes in the heart muscle.
Area of Science:
- Cardiology
- Genetics
- Electrophysiology
Background:
- Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic heart condition causing fibrosis in the right ventricle, leading to arrhythmias and heart failure.
- Diagnosis can be difficult due to varied symptoms, with electrocardiogram (ECG) playing a key role.
Purpose of the Study:
- To investigate the association between epsilon waves (EW) and late ventricular potentials (LPs) in ARVC patients.
- To analyze the correlation between right ventricular (RV) size/function and LPs/EW.
Main Methods:
- Studied 81 ARVC patients meeting 2010 International Task Force Criteria.
- Utilized 12-lead ECG, signal-averaged ECG (SAECG) for LPs, Holter monitoring, and echocardiography (ECHO).
- Compared ARVC patients with 53 patients having RV damage from atrial septum defect (ASD) or Ebstein's Anomaly (EA).
Main Results:
- A significant association was found between EW and LPs in ARVC patients (48.1% EW in LP+ vs. 6.9% in LP-, p < 0.001).
- ARVC patients with LPs showed significantly more RV dilatation (RVOT, RVIT) and dysfunction (RV S').
- Independent predictors for EW in ARVC were LAS-40 and RV S'.
Conclusions:
- An association exists between EW and LPs in ARVC, likely stemming from fibrofatty substitution of the RV myocardium.
- RV dilatation in ASD/EA patients did not correlate with LPs, differentiating them from ARVC.
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