Electrocardiographic (Ecg) Clues to Differentiate Idiopathic Right Ventricular Outflow Tract Tachycardia (Rvott) From Arrhythmogenic Right Ventricular Cardiomyopathy (Arvc) Publisher Pubmed



Emkanjoo Z¹ ; Mollazdeh R² ; Alizadeh A¹ ; Kheirkhah J¹ ; Mohammadi Z³ ; Khalili M³ ; Azhari A³ ; Shahrzad S¹ Show Affiliations
Source: Indian Heart Journal Published:2014

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. © 2014, Cardiological Society of India. All rights reserved.