The S-wave angle identifies arrhythmogenic right ventricular cardiomyopathy in patients with electrocardiographically concealed disease phenotype

Daniel Cortez, Anneli Svensson, Jonas Carlson, Sharon Graw, Nandita Sharma, Francesca Brun, Anita Spezzacatene, Luisa Mestroni, Pyotr G. Platonov

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) carries risk of sudden death. We hypothesize that the S-wave angle differentiates ARVD/C with otherwise normal electrocardiograms from controls. Materials and methods: All patients met Task Force 2010 definite ARVD/C criteria. ARVD/C patients without Task Force depolarization/repolarization criteria (−ECG) were compared to controls. Electrocardiogram measures of QRS duration, corrected QT interval, and measured angle between the upslope and downslope of the S-wave in V2, were assessed. Results: Definite ARVD/C was present in 155 patients (42.7 ± 17.3 years, 68.4%male). −ECG ARVD/C patients (66 patients) were compared to 66 control patients (41.8 ± 17.6 years, 65.2%male). Only the S-wave angle differentiated −ECG ARVD/C patients from controls (<0.001) with AU the ROC curve of 0.77 (95%CI 0.53 to 0.71) and odds ratio of 28.3 (95%CI 6.4 to 125.5). Conclusion: ARVD/C may lead to development of subtle ECG abnormalities distinguishable using the S-wave angle prior to development of 2010 Taskforce ECG criteria.

Original languageEnglish (US)
Pages (from-to)1003-1008
Number of pages6
JournalJournal of Electrocardiology
Volume51
Issue number6
DOIs
StatePublished - Nov 1 2018

Bibliographical note

Funding Information:
The study was supported by The Swedish Heart Lung Foundation . Dr. Platonov was supported by government funding of clinical research within the Swedish National Health Service , and research grants from Skåne University Hospital, Lund, Sweden . There were no conflicts of interest to report.

Publisher Copyright:
© 2018 Elsevier Inc.

Keywords

  • Arrhythmogenic right ventricular cardiomyopathy
  • Cascade screening
  • ECG
  • S-wave angle

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