Electrocardiographic Manifestations

  • Wojciech Zareba
  • Katarzyna Piotrowicz
  • Pietro Turrini


Electrocardiographic (ECG) findings usually are the first clinical abnormalities recognized in patients suspected of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) [1, 2, 3, 4, 5]. Typically, ARVC/D is considered in a young or middle-aged individual with a history of ventricular arrhythmias who does not have evidence of ischemic heart disease. The suspicion of ARVC/D is increased if the standard 12-lead ECG shows features suggestive of ARVC/D such as negative T waves in the precordial leads beyond V2 [1, 2, 3]. The standard ECG may also show abnormalities of the QRS complex, consisting of localized QRS prolongation in V1–V3 and epsilon waves indicating delayed activation of the right ventricle. Complete and incomplete right bundle branch block (RBBB) may also be observed. If the signal-averaged ECG shows late potentials, it further confirms that there is delayed ventricular activation due to myocardial fibrosis. Holter recordings assist with the diagnosis when there are frequent ventricular premature beats, (>1,000 per 24 h) usually of left bundle branch block (LBBB) morphology. As seen in Table 13.1, there is a great emphasis on ECG findings in the Task Force criteria for the diagnosis of ARVC/D [4]. This chapter provides an overview regarding the clinical significance and utility of ECG findings in patients suspected of ARVC/D.


Ventricular Arrhythmia Left Bundle Branch Block Right Bundle Branch Block Sustained Ventricular Tachycardia Precordial Lead 
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Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Wojciech Zareba
    • 1
  • Katarzyna Piotrowicz
    • 1
  • Pietro Turrini
    • 2
  1. 1.Heart Research Follow-up Program and Clinical Cardiology Research, Division of CardiologyUniversity of Rochester Medical CenterRochesterUSA
  2. 2.Department of CardiologyCivil Hospital of CamposampieroCamposampiero (PD)Italy

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