Usefulness of precordial T-wave inversion to distinguish arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia arising from the right ventricular outflow tract

Morin, Daniel P., Mauer, Andreas C., Gear, Kathleen, Zareba, Wojciech, Markowitz, Steven M., Marcus, Frank I. and Lerman, Bruce B. (2010) Usefulness of precordial T-wave inversion to distinguish arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia arising from the right ventricular outflow tract. American Journal of Cardiology, 105 12: 1821-1824. doi:10.1016/j.amjcard.2010.01.365


Author Morin, Daniel P.
Mauer, Andreas C.
Gear, Kathleen
Zareba, Wojciech
Markowitz, Steven M.
Marcus, Frank I.
Lerman, Bruce B.
Title Usefulness of precordial T-wave inversion to distinguish arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia arising from the right ventricular outflow tract
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
1879-1913
Publication date 2010-06
Sub-type Article (original research)
DOI 10.1016/j.amjcard.2010.01.365
Volume 105
Issue 12
Start page 1821
End page 1824
Total pages 4
Place of publication Bridgewater, NJ, United States
Publisher Excerpta Medica
Language eng
Formatted abstract
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 V1 to V3. For the diagnosis of ARVC, TWI in leads V1 to V3 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 V1 to V3 supports the diagnosis of ARVC.
Keyword Electrocardiographic Features
Dysplasia/cardiomyopathy
Dysplasia
Diagnosis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Available online 27 April 2010.

Document type: Journal Article
Sub-type: Article (original research)
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