Precordial t-wave inversions in patients with arrhythmogenic right ventricular cardiomyopathy who present with the initial features of right ventricular outflow tract arrhythmia

Fa Po Chung, Cheng I. Wu, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Chin Yu Lin, Ting Yung Chang, Tze Fan Chao, Jo Nan Liao, Ta Chuan Tuan, Ling Kuo, Chih Min Liu, Chye Gen Chin, Ying Chieh Liao, Shih Ann Chen

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Precordial T-wave inversion (TWI) is an important diagnostic criterion for arrhythmogenic right ventricular cardiomyopathy (ARVC). Objective: This study aimed to characterize the initial repolarization features of definite ARVC in patients who first presented with right ventricular outflow tract ventricular arrhythmia (RVOT-VA) and TWI. Methods: Patients who presented with RVOT-VA and TWI ≥ V2 were retrospectively assessed. The initial characteristics of repolarization between patients with and without a final diagnosis of definite ARVC during follow-up were compared. Results: TWI ≥ V2 was observed in 61 of 553 patients (mean age: 44.1 ± 14.7 years; 14 men) with RVOT-VAs. After an average follow-up time of 54.9 ± 33.7 months, 31 (50.8%) patients were classified into the definite ARVC group and 30 (49.2%) into the non-definite ARVC group. The disappearance of precordial TWI ≥ V2 was observed in eight (13.1%) patients after the elimination of RVOT-VAs. In a multivariate analysis of the initial electrocardiogram features, only fragmented QRS [odds ratio (OR): 15.45, 95% confidence interval (CI): 1.61-148.26, p = 0.02] and precordial V2 TpTe interval (OR: 1.03, 95% CI: 1.01-1.06, p = 0.02) could independently predict definite ARVC during longitudinal follow-up. An initial V2 TpTe cutoff value > 88.5 ms could predict the final diagnosis of definite ARVC, with a sensitivity and specificity of 74.2% and 78.6%, respectively. Conclusions: Despite the high risk of ARVC in RVOT-VAs and TWI ≥ V2, “normalization” of TWI was observed after ventricular arrhythmia elimination in 13.1% of the patients. Fragmented QRS and longer V2 TpTe interval were associated with definite ARVC during longitudinal follow-up.

Original languageEnglish
Pages (from-to)464-474
Number of pages11
JournalActa Cardiologica Sinica
Volume36
Issue number5
DOIs
Publication statusPublished - 2020

Keywords

  • Arrhythmogenic right ventricular cardiomyopathy
  • Radiofrequency catheter ablation
  • Right ventricular outflow tract arrhythmia
  • T-wave inversion
  • Tpeak-Tend interval

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Precordial t-wave inversions in patients with arrhythmogenic right ventricular cardiomyopathy who present with the initial features of right ventricular outflow tract arrhythmia'. Together they form a unique fingerprint.

Cite this