Electrocardiographic Pattern in Arrhythmogenic Right Ventricular Cardiomyopathy

Steriotis, Alexandros; Bauce, Barbara; Daliento, Luciano; Rigato, Ilaria; Mazzotti, Elisa; Folino, Antonio Franco; Marra, Martina Perazzolo; Brugnaro, Luca; Nava, Andrea

doi:10.1016/j.amjcard.2009.01.017

Cited by 85 publications

(72 citation statements)

References 23 publications

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“…Several studies have demonstrated LP in the SAECG of humans with ARVC (Blomström-Lundqvist et al, 1988;Blomström-Lundqvist et al, 1989;Leclercq, Coumel, 1993;Kinoshita et al, 1995;Turrini et al, 1999;Nava et al, 2000;Steriotis et al, 2009;Marcus et al, 2010), although this result has been regarded as a minor criterion in the diagnosis of the disease (Marcus et al, 2010). LP was also commonly observed in Boxer dogs with ARVC (Spier et al, 2001;Spier, Meurs, 2004b).…”

Section: Discussionmentioning

confidence: 99%

“…In human medicine, the SAECG is abnormal when there are changes in at least two parameters analyzed using a specific type of filter (Leclercq, Coumel, 1993;Turrini et al, 1999;Steriotis et al, 2009). There are, however, differences in test interpretation in veterinary medicine.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is controversy regarding the optimal filter to be used, bidirectional 25 to 250 Hz or 40 to 250 Hz filters are used most frequently (Breithardt et al, 1991). Some studies in humans, however, also use the 80 to 250 Hz filter and often compare the SAECG results obtained with these three types of filters (Turrini et al, 1999;Folino et al, 2006;Steriotis et al, 2009). In dogs, most SAECG studies are performed using only the 40 to 250 Hz filter (Kushner et al, 1996;Calvert et al, 1998a;Calvert et al, 1998b;Ferreira, Camacho, 2005).…”

Section: Discussionmentioning

confidence: 99%

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Time-domain signal-averaged electrocardiogram in healthy German Shepherd and Boxer dogs

Chamas¹,

Oliveira²,

Yamaki³

et al. 2014

Arq. Bras. Med. Vet. Zootec.

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Signal-averaged electrocardiogram (SAECG) identifies ventricular late potentials (LP), low-amplitude electrical signals that are markers of slow cardiac conduction in fibrous myocardium, consisting in a predictive factor for sudden death in dogs at risk of sustained ventricular tachycardia. The aim of this study was to establish reference values of SAECG for German Shepherd and Boxer dogs. SAECG was performed in 19 German Shepherd and 28 Boxer client-owned dogs, and parameters analyzed were QRSd (duration of filtered QRS), LAS<40V (duration of low-amplitude signals in terminal portion of filtered QRS) and RMS40 (root square of mean voltage over the last 40 milliseconds of filtered QRS), with two different filters (25-250 Hz and 40-250 Hz). Statistical analyses was achieved by T Student test (p<0.05) to identify differences between the two groups and between the values obtained with the two filters. No statistical difference was found in SAECG variables between the two breeds with the two different filters (p>0.05). Achieving normal values of SAECG in German Shepherd and Boxer dogs is important to further research late potentials in animals of these breeds with hereditary ventricular tachycardia or arrhythmogenic cardiomyopathy and identification of individuals at high risk of cardiac-related sudden death.Keywords: canine, high-resolution electrocardiography, ventricular tachycardia, arrhythmogenic right ventricular cardiomyopathy Student (p<0,05) RESUMO O eletrocardiograma de alta resolução (ECGAR) identifica os potenciais tardios (PT), sinais elétricos de baixa amplitude considerados marcadores de condução cardíaca lenta de áreas fibrosadas do miocárdio, cuja presença consiste em fator preditivo de morte súbita em cães com taquicardia ventricular sustentada. O objetivo deste estudo foi o estabelecimento de valores de referência para o ECGAR de cães Boxer (n=28) e Pastor Alemão (n=19). Os seguintes parâmetros do ECGAR foram analisados: dQRS (duração do QRS filtrado), LAS<40V (duração dos sinais de baixa amplitude no final do QRS filtrado) e RMS40 (raiz quadrada da voltagem média do final do QRS filtrado), com dois tipos diferentes de filtro (25-250 Hz e 40-250 Hz). Análise estatística foi realizada por meio do teste T de

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Time-domain signal-averaged electrocardiogram in healthy German Shepherd and Boxer dogs

Chamas¹,

Oliveira²,

Yamaki³

et al. 2014

Arq. Bras. Med. Vet. Zootec.

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“…More than 80% of ARVC patients will have abnormalities on the ECG [10,11]. Repolarization abnormalities, such as TWI in the anterior precordial leads and delayed S wave upstroke, are early and sensitive markers of disease expression in patients with ARVC.…”

Section: Introductionmentioning

confidence: 99%

Signs of RV overload on the athlete’s ECG

Claessen

Brosnan

Gerche

et al. 2015

Journal of Electrocardiology

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There is increasing evidence that regular intense endurance exercise can promote structural and electrical remodeling of the right ventricle (RV). These physiological changes can be profound and are frequently accompanied by ECG changes in the right precordial leads, thereby mimicking features observed in arrhythmogenic right ventricular cardiomyopathy (ARVC). Because the 12-lead ECG is used as both a screening and diagnostic tool for the detection of conditions associated with sudden death in athletes, it is of fundamental importance to have a good understanding of the ECG features that distinguish physiological adaptations to endurance exercise from those related to RV pathology as well as their potential overlap. This article describes ECG findings observed in healthy endurance athletes versus athletes with underlying RV pathology and illustrates their differentiation using 4 case presentations.

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“…This will include T-wave inversions in the right precordial leads, sometimes also involving V4-6, slurred S-wave upstroke in V1-3 ≥55 ms (see Figure 3), and with more advanced stages e waves. 107 The interpretation of e waves significantly varies among observers. Furthermore, e waves occur at more advanced stages, when the vast majority of patients already fulfils other TFC for definite diagnosis.…”

Section: -Lead Surface Ecg and Signal-averaged Ecgmentioning

confidence: 99%

Arrhythmogenic Cardiomyopathy: Electrical and Structural Phenotypes

Akdiş

Brunckhorst

Duru

et al. 2016

Arrhythmia &Amp; Electrophysiology Review

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This overview gives an update on the molecular mechanisms, clinical manifestations, diagnosis and therapy of arrhythmogenic cardiomyopathy (ACM). ACM is mostly hereditary and associated with mutations in genes encoding proteins of the intercalated disc. Three subtypes have been proposed: the classical right-dominant subtype generally referred to as ARVC/D, biventricular forms with early biventricular involvement and left-dominant subtypes with predominant LV involvement. Typical symptoms include palpitations, arrhythmic (pre)syncope and sudden cardiac arrest due to ventricular arrhythmias, which typically occur in athletes. At later stages, heart failure may occur. Diagnosis is established with the 2010 Task Force Criteria (TFC). Modern imaging tools are crucial for ACM diagnosis, including both echocardiography and cardiac magnetic resonance imaging for detecting functional and structural alternations. Of note, structural findings often become visible after electrical alterations, such as premature ventricular beats, ventricular fibrillation (VF) and ventricular tachycardia (VT). 12-lead ECG is important to assess for depolarisation and repolarisation abnormalities, including T-wave inversions as the most common ECG abnormality. Family history and the detection of causative mutations, mostly affecting the desmosome, have been incorporated in the TFC, and stress the importance of cascade family screening. Differential diagnoses include idiopathic right ventricular outflow tract (RVOT) VT, sarcoidosis, congenital heart disease, myocarditis, dilated cardiomyopathy, athlete’s heart, Brugada syndrome and RV infarction. Therapeutic strategies include restriction from endurance and competitive sports, β-blockers, antiarrhythmic drugs, heart failure medication, implantable cardioverter-defibrillators and endocardial/epicardial catheter ablation.

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Electrocardiographic Pattern in Arrhythmogenic Right Ventricular Cardiomyopathy

Cited by 85 publications

References 23 publications

Time-domain signal-averaged electrocardiogram in healthy German Shepherd and Boxer dogs

Time-domain signal-averaged electrocardiogram in healthy German Shepherd and Boxer dogs

Signs of RV overload on the athlete’s ECG

Arrhythmogenic Cardiomyopathy: Electrical and Structural Phenotypes

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