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Epsilon waves detected by various electrocardiographic recording methods: in patients with arrhythmogenic right ventricular cardiomyopathy.
Tex Heart Inst J. 2010; 37(4):405-11.TH

Abstract

We analyzed the shape and distribution of epsilon waves by 3 various methods of electrocardiographic recording in patients with arrhythmogenic right ventricular cardiomyopathy.Thirty-two patients who met recognized diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy were included in this study (24 men and 8 women; mean age, 42.3 ± 12.9 yr). Epsilon waves were detected by standard 12-lead electrocardiography (S-ECG), right-sided precordial lead electrocardiography (R-ECG), and Fontaine bipolar precordial lead electrocardiography (F-ECG). We found 3 types of epsilon waves: wiggle waves, small spike waves, and smooth potential waves that formed an atypical prolonged R' wave. The most common configuration was small spiked waves. In some circumstances, epsilon waves were evident in some leads (especially in leads V(1) through V(3)), but notches were recorded in the other leads during the corresponding phase. These waves could be detected only by S-ECG in 1 patient, R-ECG in 3 patients, and F-ECG in 5 patients; the rates of epsilon-wave detection by these 3 methods were 38% (12/32), 38% (12/32), and 50% (16/32), respectively. However, the detection rate using combined methods was significantly higher than that by S-ECG alone (SF-ECG 56% vs S-ECG 38%, P = 0.0312; and SRF-ECG 66% vs S-ECG 38%, P = 0.0039). In addition, the rate of widespread T-wave inversion (exceeding V(3)) was significantly higher in patients with epsilon waves than in those without (48% vs 9%, P = 0.029), as was ventricular tachycardia (95% vs 64%, P = 0.019).These 3 electrocardiographic recording methods should be used in combination to improve the detection rate of epsilon waves.

Authors+Show Affiliations

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20844612

Citation

Wang, Jing, et al. "Epsilon Waves Detected By Various Electrocardiographic Recording Methods: in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy." Texas Heart Institute Journal, vol. 37, no. 4, 2010, pp. 405-11.
Wang J, Yang B, Chen H, et al. Epsilon waves detected by various electrocardiographic recording methods: in patients with arrhythmogenic right ventricular cardiomyopathy. Tex Heart Inst J. 2010;37(4):405-11.
Wang, J., Yang, B., Chen, H., Ju, W., Chen, K., Zhang, F., Cao, K., & Chen, M. (2010). Epsilon waves detected by various electrocardiographic recording methods: in patients with arrhythmogenic right ventricular cardiomyopathy. Texas Heart Institute Journal, 37(4), 405-11.
Wang J, et al. Epsilon Waves Detected By Various Electrocardiographic Recording Methods: in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy. Tex Heart Inst J. 2010;37(4):405-11. PubMed PMID: 20844612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epsilon waves detected by various electrocardiographic recording methods: in patients with arrhythmogenic right ventricular cardiomyopathy. AU - Wang,Jing, AU - Yang,Bing, AU - Chen,Hongwu, AU - Ju,Weizhu, AU - Chen,Kai, AU - Zhang,Fengxiang, AU - Cao,Kejiang, AU - Chen,Minglong, PY - 2010/9/17/entrez PY - 2010/9/17/pubmed PY - 2011/1/14/medline KW - Arrhythmias, cardiac/etiology KW - arrhythmogenic right ventricular dysplasia/diagnosis KW - cell communications/genetics KW - electrocardiography/methods/standards KW - epsilon waves KW - gap junctions KW - genetic predisposition to disease KW - heart function tests KW - sensitivity and specificity KW - ventricular dysfunction, right SP - 405 EP - 11 JF - Texas Heart Institute journal JO - Tex Heart Inst J VL - 37 IS - 4 N2 - We analyzed the shape and distribution of epsilon waves by 3 various methods of electrocardiographic recording in patients with arrhythmogenic right ventricular cardiomyopathy.Thirty-two patients who met recognized diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy were included in this study (24 men and 8 women; mean age, 42.3 ± 12.9 yr). Epsilon waves were detected by standard 12-lead electrocardiography (S-ECG), right-sided precordial lead electrocardiography (R-ECG), and Fontaine bipolar precordial lead electrocardiography (F-ECG). We found 3 types of epsilon waves: wiggle waves, small spike waves, and smooth potential waves that formed an atypical prolonged R' wave. The most common configuration was small spiked waves. In some circumstances, epsilon waves were evident in some leads (especially in leads V(1) through V(3)), but notches were recorded in the other leads during the corresponding phase. These waves could be detected only by S-ECG in 1 patient, R-ECG in 3 patients, and F-ECG in 5 patients; the rates of epsilon-wave detection by these 3 methods were 38% (12/32), 38% (12/32), and 50% (16/32), respectively. However, the detection rate using combined methods was significantly higher than that by S-ECG alone (SF-ECG 56% vs S-ECG 38%, P = 0.0312; and SRF-ECG 66% vs S-ECG 38%, P = 0.0039). In addition, the rate of widespread T-wave inversion (exceeding V(3)) was significantly higher in patients with epsilon waves than in those without (48% vs 9%, P = 0.029), as was ventricular tachycardia (95% vs 64%, P = 0.019).These 3 electrocardiographic recording methods should be used in combination to improve the detection rate of epsilon waves. SN - 1526-6702 UR - https://www.unboundmedicine.com/medline/citation/20844612/Epsilon_waves_detected_by_various_electrocardiographic_recording_methods:_in_patients_with_arrhythmogenic_right_ventricular_cardiomyopathy_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=20844612.ui DB - PRIME DP - Unbound Medicine ER -