Risk stratification of arrhythmogenic right ventricular cardiomyopathy based on signal averaged electrocardiograms |
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Authors: | Ying-Chieh Liao Yenn-Jiang Lin Fa-Po Chung Shih-Lin Chang Li-Wei Lo Yu-Feng Hu Tze-Fan Chao Eric Chung Ta-Chuan Tuan Jin-Long Huang Jo-Nan Liao Yun-Yu Chen Shih-Ann Chen |
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Institution: | 1. Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan;2. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;3. Division of Cardiology, Department of Medicine, Buddhist Tzu-Chi General Hospital, Taichung branch, Taichung, Taiwan;4. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan;5. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan |
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Abstract: | BackgroundSignal averaged electrocardiogram (SAECG) is a specific and non-invasive tool useful for arrhythmogenic right ventricular cardiomyopathy (ARVC) diagnosis. However, its role in risk stratification of patients with ARVC remains largely undefined.MethodsSixty-four patients fulfilling Task Force ARVC criteria (mean age: 47 ± 14 years-old, 56% male, 50% definite ARVC) were enrolled. The baseline demographic, electrocardiographic, structural, and electrophysiological characteristics were collected. Patients with SAECG fulfilling all 3 Task Force criteria (3 + SAECG) were categorized into group 1, and those fulfilled 2 or less criterion were categorized into group 2. The study endpoints were unstable ventricular arrhythmia (VA), device detectable sustained fast VA (cycle lengths < 240 ms) and cardiovascular death.ResultsDuring a mean follow-up of 21 ± 20 months, 15 primary endpoints including 12 unstable VAs and 3 device-detected fast VAs were met. One patient died of electrical storm, and one patient underwent heart transplantation. The presence of 3 + SAECG predicted malignant events in all patients with definite and non-definite ARVC (p < 0.01, OR = 30.5, 95% CI = 2.5–373.7) and in patients with definite ARVC alone (p = 0.03, OR = 11.1, 95% CI = 1.3–93.9). Patients diagnosed with non-definite ARVC without 3 + SAECG were free from malignant events.ConclusionsSAECG fulfilling all 3 Task Force criteria was an independent risk predictor of malignant events in ARVC patients. SAECG may play a valuable role in ARVC risk stratification. |
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Keywords: | Signal-averaged electrocardiogram Arrhythmogenic right ventricular cardiomyopathy Ventricular arrhythmia |
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