| Value of the signal-averaged electrocardiogram in arrhythmogenic right ventricular cardiomyopathy/dysplasia. | |
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MedLine Citation:
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PMID: 20933608 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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 |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural Date: 2010-10-08 |
Journal Detail:
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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:
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Created Date: 2011-01-31 Completed Date: 2011-06-16 Revised Date: 2012-02-02 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 256-62 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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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:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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