Multichannel electrocardiogram diagnostics for the diagnosis of arrhythmogenic right ventricular dysplasia

Ricards Marcinkevics, James O'Neill, Hannah Law, Eleftheria Pervolaraki, Andrew Hogarth, Craig Russell, Berthold Stegemann, Arun V Holden, Muzahir H Tayebjee
2017 Europace  
-The identification of arrhythmogenic right ventricular dysplasia (ARVD) from 12 channel standard ECG is challenging. High density ECG data may identify lead locations and criteria with a higher sensitivity. Methods and Results -80 channel ECG recording from patients diagnosed with ARVD and controls were quantified by magnitude and integral measures of QRS and T waves, and by a measure (the average silhouette width) of differences in the shapes of the normalised ECG cycles. The channels with
more » ... best separability between ARVD patients and controls were near the right ventricular wall, at the third intercostal space. These channels showed pronounced differences in P waves compared to controls, as well as the expected differences in QRS and T waves. Conclusions -Multichannel recordings, as in body surface mapping, adds little to the reliability of diagnosing ARVD from ECGs. However, repositioning ECG electrodes to a high anterior position can improve the identification of ECG variations in ARVD. Additionally, increased P wave amplitude appears to be associated with ARVD. Arrhythmogenic right ventricular cardiomyopathy Arrhythmogenic right ventricular dysplasia Multichannel ECG recording P wave amplitude Multichannel ECG diagnostics for the diagnosis of arrhythmogenic right ventricular dysplasia Condensed abstract This study examines the use of 80-lead ECGs in the diagnosis of arrhythmogenic right ventricular dysplasia (ARVD). Findings show that high anterior chest lead positions improve diagnosis of ARVD and interestingly, ARVD patients have increased P-wave amplitude. However, additional channels of 80-lead ECGs add little in the diagnosis of ARVD. Total word count: 3,049 words Journal Subject Terms: Arrhythmia, Electrocardiogram (ECG) 1 What's New?  80 channel ECG recordings from ARVD patient and control groups allow the selection of recording sites that are best for separating the ECG waveforms between the two groups, using methods based on the ECG waveform rather than measures of amplitudes and durations of its components.  These methods show that high anterior chest lead positions provide the most discrimination between ARVD patients and controls and demonstrate well-known differences in T wave polarity and QRS integral.  There is also an association between increased P wave amplitude and the presence of ARVD.  The additional channels of the 80-lead ECGs add little to the discriminability between ARVD patients and controls.
doi:10.1093/europace/eux124 pmid:29016773 fatcat:o67ieddd5ffzrjwj6hfbzdrc7a