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Mega-epsilon waves on 12-lead ECG--just another case of arrhythmogenic right ventricular dysplasia/cardiomyopathy?
J Electrocardiol. 2013 Nov-Dec; 46(6):524-7.JE

Abstract

Epsilon wave, the post-excitation small squiggles at the beginning of ST segment that first named by Fontaine, is a well-known ECG phenomenon frequently associated with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Epsilon waves are caused by post excitation of the myocytes in the right ventricle due to myocardial scaring. Increasing evidence suggests that cardiac sarcoidosis might produce the pathological substrate required for production of epsilon waves. Therefore differentiating these two entities is of paramount clinical importance. Here we report a case demonstrating mega-epsilon wave, right ventricular dilatation and inducible ventricular tachycardia (VT) that was initially diagnosed as ARVD/C by the Task Force Criteria. However after a thorough evaluation, diagnosis of cardiac sarcoidosis was confirmed by the evidence of non-caseating granulomas from endomycardial biopsy.

Authors+Show Affiliations

Lankenua Medical Centre, Wynnewood, PA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24016846

Citation

Khaji, Amanulla, et al. "Mega-epsilon Waves On 12-lead ECG--just Another Case of Arrhythmogenic Right Ventricular Dysplasia/cardiomyopathy?" Journal of Electrocardiology, vol. 46, no. 6, 2013, pp. 524-7.
Khaji A, Zhang L, Kowey P, et al. Mega-epsilon waves on 12-lead ECG--just another case of arrhythmogenic right ventricular dysplasia/cardiomyopathy? J Electrocardiol. 2013;46(6):524-7.
Khaji, A., Zhang, L., Kowey, P., Martinez-Lage, M., & Kocovic, D. (2013). Mega-epsilon waves on 12-lead ECG--just another case of arrhythmogenic right ventricular dysplasia/cardiomyopathy? Journal of Electrocardiology, 46(6), 524-7. https://doi.org/10.1016/j.jelectrocard.2013.08.007
Khaji A, et al. Mega-epsilon Waves On 12-lead ECG--just Another Case of Arrhythmogenic Right Ventricular Dysplasia/cardiomyopathy. J Electrocardiol. 2013 Nov-Dec;46(6):524-7. PubMed PMID: 24016846.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mega-epsilon waves on 12-lead ECG--just another case of arrhythmogenic right ventricular dysplasia/cardiomyopathy? AU - Khaji,Amanulla, AU - Zhang,Li, AU - Kowey,Peter, AU - Martinez-Lage,Maria, AU - Kocovic,Dusan, Y1 - 2013/09/07/ PY - 2013/06/27/received PY - 2013/9/11/entrez PY - 2013/9/11/pubmed PY - 2014/8/1/medline KW - AV block KW - Arrhythmogenic right ventricular dysplasia KW - Cardiac sarcoidosis KW - Epsilon wave SP - 524 EP - 7 JF - Journal of electrocardiology JO - J Electrocardiol VL - 46 IS - 6 N2 - Epsilon wave, the post-excitation small squiggles at the beginning of ST segment that first named by Fontaine, is a well-known ECG phenomenon frequently associated with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Epsilon waves are caused by post excitation of the myocytes in the right ventricle due to myocardial scaring. Increasing evidence suggests that cardiac sarcoidosis might produce the pathological substrate required for production of epsilon waves. Therefore differentiating these two entities is of paramount clinical importance. Here we report a case demonstrating mega-epsilon wave, right ventricular dilatation and inducible ventricular tachycardia (VT) that was initially diagnosed as ARVD/C by the Task Force Criteria. However after a thorough evaluation, diagnosis of cardiac sarcoidosis was confirmed by the evidence of non-caseating granulomas from endomycardial biopsy. SN - 1532-8430 UR - https://www.unboundmedicine.com/medline/citation/24016846/Mega_epsilon_waves_on_12_lead_ECG__just_another_case_of_arrhythmogenic_right_ventricular_dysplasia/cardiomyopathy L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-0736(13)00413-5 DB - PRIME DP - Unbound Medicine ER -