Document Detail


Usefulness of precordial T-wave inversion to distinguish arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia arising from the right ventricular outflow tract.
MedLine Citation:
PMID:  20538137     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The 2 predominant causes of ventricular tachycardia (VT) arising from the right ventricle are arrhythmogenic right ventricular cardiomyopathy (ARVC) and idiopathic VT arising from the right ventricular outflow tract (RVOT). These arrhythmias can be adrenergically mediated and may be difficult to distinguish clinically. A minor criterion for the diagnosis of ARVC is T-wave inversion (TWI) in the right precordial leads during sinus rhythm. However, there have been reports of precordial TWI identified in patients with RVOT tachycardia. The purpose of this study was to determine whether patterns of precordial TWI could differentiate between the 2 groups. A multicenter registry of 229 patients with VT of right ventricular origin was evaluated. After appropriate exclusions (n = 29), 79 patients (58% men, mean age 40 +/- 14 years) had ARVC, and 121 patients (41% men, mean age 48 +/- 14 years) had RVOT tachycardia. During sinus rhythm, 37 patients (47%) with ARVC and 5 patients (4%) with RVOT tachycardia had TWI in leads V(1) to V(3). For the diagnosis of ARVC, TWI in leads V(1) to V(3) had sensitivity of 47% and specificity of 96%. In conclusion, in patients with VT of right ventricular origin, the presence of TWI in electrocardiographic leads V(1) to V(3) supports the diagnosis of ARVC.
Authors:
Daniel P Morin; Andreas C Mauer; Kathleen Gear; Wojciech Zareba; Steven M Markowitz; Frank I Marcus; Bruce B Lerman
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2010-04-27
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-11     Completed Date:  2010-07-06     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1821-4     Citation Subset:  AIM; IM    
Affiliation:
Ochsner Medical Center, New Orleans, LA, USA. daniel@massmed.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Arrhythmogenic Right Ventricular Dysplasia / diagnosis*,  physiopathology
Diagnosis, Differential
Electrocardiography / methods*
Endocardium
Female
Follow-Up Studies
Heart Conduction System / physiopathology*
Heart Rate / physiology*
Heart Ventricles / innervation*,  physiopathology
Humans
Male
Middle Aged
Reproducibility of Results
Tachycardia, Ventricular / diagnosis*,  physiopathology
Grant Support
ID/Acronym/Agency:
U01 HL065594-05/HL/NHLBI NIH HHS; U01 HL065652-05/HL/NHLBI NIH HHS; U01 HL065691-05/HL/NHLBI NIH HHS; U0165652//PHS HHS; U01HL65594/HL/NHLBI NIH HHS; U01HL65691/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Am J Cardiol. 2010 Nov 15;106(10):1522   [PMID:  21059451 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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