Abstract 11319: The Role of De-/Repolarization Abnormalities for Risk Prediction in Arrhythmogenic Right Ventricular Cardiomyopathy
Introduction: The value of electrocardiographic findings in predicting adverse outcome in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is currently under investigation.
Hypothesis: We hypothesized that ventricular de-/repolarization abnormalities on 12-lead ECG predict adverse outcome in our large cohort of patients with ARVC.
Methods and Results: The baseline 12-lead ECGs of 111 patients who fulfilled the 2010 ARVC Task Force Criteria (TFC) from the Zurich ARVC Registry were digitized, and each ECG was analyzed with a digital caliper by two independent observers blinded to the outcome data. ECGs were compared in two patient groups: (1) patients with major adverse cardiovascular events (MACE: a composite of cardiac death, heart transplantation, survived sudden cardiac death, ventricular fibrillation, sustained ventricular tachycardia or arrhythmic syncope) and (2) all remaining patients. 51 patients (46%) experienced MACE during a median follow-up period of 4.4 (IQR 1.8-10.0) years. Kaplan-Meier analysis revealed a reduced cumulative survival among patients with repolarization abnormalities according to TFC (p<0.001), QRS fragmentation (p=0.026) and a precordial QRS amplitude ratio (V1+V2+V3/ V1+V2+V3+V4+V5+V6) of ≤0.48 (p=0.049) (Figure). Presence of depolarization abnormalities according to TFC, parietal block, peripheral low voltage, QT prolongation, increased QT dispersion and prolonged Tpeak-Tend interval did not predict MACE.
Conclusions: Our long-term data from the Zurich ARVC Registry suggests that precordial T-wave inversions, QRS fragmentation and a QRS amplitude ratio of ≤0.48 may be useful ECG parameters for risk stratification in patients with ARVC.
- © 2013 by American Heart Association, Inc.