UMEM Educational Pearls

ECG Risk Predication in ARVD

Arrhythmogenic right ventricular dysplasia (ARVD) is a genetically determined cardiomyopathy characterized by fibrofatty replacement of the right ventricle (RV) predisposing to ventricular arrhythmias, heart failure, and sudden cardiac death (SCD).

Twelve-lead electrocardiography (ECG) is an easily obtainable and noninvasive risk stratification tool for major adverse cardiac event (MACE); defined as a composite of cardiac death, heart transplantation, survived sudden cardiac death, ventricular fibrillation, sustained ventricular tachycardia, or arrhythmic syncope.

ARVD ECG findings that predict adverse outcome are not well known.

A multicenter, observational, long-term study, found ECG findings were quite useful for risk stratification of MACE, specifically:

-       Repolarization criteria

-       Inferior leads T wave inversions

-       Precordial QRS amplitude ratio of ≤0.48

-       QRS fragmentation 

References

Saguner A, Ganahi S, et al. Usefulness of Electrocardiographic Parameters for Risk Prediction in Arrhythmogenic right ventricular dysplasia. American Journal of Cardiology. May 15, 2014. Vol 113, Issue 10,1728-34.