Clinical Electrophysiology -> Ventricular Arrhythmias -> Electrocardiography D-PO05 - Poster Session V (ID 39) Poster

D-PO05-235 - Precordial T-wave Inversions In Patients With Arrhythmogenic Right Ventricular Cardiomyopathy Who Present With The Initial Features Of Right Ventricular Outflow Tract Arrhythmia (ID 602)


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 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; 14 men) with RVOT-VAs. After an average follow-up time of 54.9 ± 33.7 months, 31 (50.8%) patients were classified under the definite ARVC group and 30 (49.2%) under 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 the 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.
Conclusion: Despite the high risk of ARVC in RVOT-VAs and TWI ≥V2, “normalization” of TWI was observed after VA elimination in 13.1% of patients. The fragmented QRS and longer V2 TpTe interval were found to be associated with definite ARVC during the longitudinal follow-up.