Prevalence and Prognostic Significance of T-Wave Inversions in Right Precordial Leads of a 12-Lead Electrocardiogram in the Middle-Aged Subjects
Background—T-wave inversion in right precordial leads V1-V3 is a relatively common finding in a 12-lead electrocardiogram (ECG) of children and adolescents and is infrequently found also in healthy adults. However, this ECG pattern can also be the first presentation of arrhythmogenic right ventricular cardiomyopathy (ARVC). The prevalence and prognostic significance of T-wave inversions in the middle-aged general population are not well known.
Methods and Results—We evaluated 12-lead ECGs of 10899 Finnish middle-aged subjects (52% males, mean age 44±8.5 years) recorded between 1966 and 1972 for the presence of inverted T-waves and followed the subjects for 30±11 years. Primary endpoints were all-cause mortality, cardiac mortality, and arrhythmic death. T-wave inversions in right precordial leads V1-V3 were present in 54 (0.5%) of the subjects. In addition, 76 (0.7%) of the subjects had inverted T-waves present only in leads other than V1-V3. Right precordial T-wave inversions did not predict increased mortality (NS for all endpoints). However, inverted T-waves in leads other than V1-V3 were associated with an increased risk of cardiac and arrhythmic death (p<0.001 for both).
Conclusions—T-wave inversions in right precordial leads are relatively rare in the general population, and are not associated with adverse outcome. Increased mortality risk associated with inverted T-waves in other leads may reflect the presence of an underlying structural heart disease.
- Received February 8, 2012.
- Accepted March 27, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited