Document Detail


Value of the signal-averaged electrocardiogram in arrhythmogenic right ventricular cardiomyopathy/dysplasia.
MedLine Citation:
PMID:  20933608     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is an inherited disease that causes structural and functional abnormalities of the right ventricle (RV). The presence of late potentials as assessed by the signal-averaged electrocardiogram (SAECG) is a minor task force criterion.
OBJECTIVE: The purpose of this study was to examine the diagnostic and clinical value of the SAECG in a large population of genotyped ARVC/D probands.
METHODS: We compared the SAECGs of 87 ARVC/D probands (age 37 ± 13 years, 47 males) diagnosed as affected or borderline by task force criteria without using the SAECG criterion with 103 control subjects. The association of SAECG abnormalities was also correlated with clinical presentation, surface ECG, ventricular tachycardia (VT) inducibility at electrophysiologic testing, implantable cardioverter-defibrillator therapy for VT, and RV abnormalities as assessed by cardiac magnetic resonance imaging (cMRI).
RESULTS: Compared with controls, all three components of the SAECG were highly associated with the diagnosis of ARVC/D (P <.001). They include the filtered QRS duration (97.8 ± 8.7 ms vs 119.6 ± 23.8 ms), low-amplitude signal (24.4 ± 9.2 ms vs 46.2 ± 23.7 ms), and root mean square amplitude of the last 40 ms of the QRS (50.4 ± 26.9 μV vs 27.9 ± 36.3 μV). The sensitivity of using SAECG for diagnosis of ARVC/D was increased from 47% using the established 2 of 3 criteria (i.e., late potentials) to 69% by using a modified criterion of any 1 of 3 criteria, while maintaining a high specificity of 95%. Abnormal SAECG as defined by this modified criterion was associated with a dilated RV volume and decreased RV ejection fraction detected by cMRI (P <.05). SAECG abnormalities did not vary with clinical presentation or reliably predict spontaneous or inducible VT and had limited correlation with ECG findings.
CONCLUSION: Using 1 of 3 SAECG criteria contributed to increased sensitivity and specificity for the diagnosis of ARVC/D. This finding is incorporated in the recent modification of the task force criteria.
Authors:
Ganesh S Kamath; Wojciech Zareba; Jessica Delaney; Jayanthi N Koneru; William McKenna; Kathleen Gear; Slava Polonsky; Duane Sherrill; David Bluemke; Frank Marcus; Jonathan S Steinberg
Related Documents :
15817088 - Comparison between qrs duration at standard ecg and signal-averaging ecg for arrhythmic...
6849248 - Relation between late potentials on the body surface and directly recorded fragmented e...
16697318 - Isolated potentials during sinus rhythm and pace-mapping within scars as guides for abl...
3409498 - Comparison of individual and combined effects of procainamide and amiodarone in patient...
20398658 - Activation of catalase by apelin prevents oxidative stress-linked cardiac hypertrophy.
19089938 - Pci versus cabg for multivessel coronary disease in diabetics.
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2010-10-08
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  8     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-31     Completed Date:  2011-06-16     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  256-62     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Al-Sabah Arrhythmia Institute, St. Luke's and Roosevelt Hospitals, and Columbia University College of Physicians & Surgeons, New York, New York 10025, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Arrhythmias, Cardiac / complications,  diagnosis*,  therapy
Arrhythmogenic Right Ventricular Dysplasia / complications,  diagnosis*,  therapy
Cardiac Pacing, Artificial / methods
Case-Control Studies
Chi-Square Distribution
Defibrillators, Implantable
Electrocardiography / methods*
Female
Heart Ventricles / abnormalities
Humans
Magnetic Resonance Imaging / methods*
Male
Middle Aged
ROC Curve
Reference Values
Reproducibility of Results
Severity of Illness Index
Young Adult
Grant Support
ID/Acronym/Agency:
HL65652/HL/NHLBI NIH HHS; HL65691/HL/NHLBI NIH HHS; U01 HL065594-02/HL/NHLBI NIH HHS; U01 HL065594-03/HL/NHLBI NIH HHS; U01 HL065594-04/HL/NHLBI NIH HHS; U01 HL065594-05/HL/NHLBI NIH HHS; U01 HL65594/HL/NHLBI NIH HHS; ZIA CL090019-01/CL/CLC NIH HHS; ZIA EB000072-01/EB/NIBIB NIH HHS
Comments/Corrections

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


Previous Document:  Anti-aggregating effect of BAY 58-2667, an activator of soluble guanylyl cyclase.
Next Document:  Pleiotropic mutations in ion channels: What lies behind them?