Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Natural Course of Electrocardiographic Features in Arrhythmogenic Right Ventricular Cardiomyopathy and Their Relation to Ventricular Arrhythmic Events

Svensson, Anneli LU ; Jensen, Henrik Kjaerulf ; Boonstra, Machteld J. ; Tétreault-Langlois, Marianne ; Dahlberg, Pia LU ; Bundgaard, Henning ; Christensen, Alex Hørby ; Rylance, Rebecca T. LU orcid ; Svendsen, Jesper H. and Cadrin-Tourigny, Julia , et al. (2024) In Journal of the American Heart Association 13(16).
Abstract

BACKGROUND: Electrocardiographic abnormalities are common in arrhythmogenic right ventricular cardiomyopathy and are included in the 2010 Task Force Criteria. Their time course, however, remains uncertain. In this retrospective observational study, we aimed to assess the long-term evolution of electrocardiographic characteristics and their relation to ventricular arrhythmias. METHODS AND RESULTS: Three hundred fifty-three patients with arrhythmogenic right ventricular cardiomyopathy as per the 2010 Task Force Criteria with 6871 automatically processed 12-lead digital ECGs were included. The relationship between the electrocardiographic parameters and the risk of ventricular arrhythmias was assessed at 10 years from the first ECG.... (More)

BACKGROUND: Electrocardiographic abnormalities are common in arrhythmogenic right ventricular cardiomyopathy and are included in the 2010 Task Force Criteria. Their time course, however, remains uncertain. In this retrospective observational study, we aimed to assess the long-term evolution of electrocardiographic characteristics and their relation to ventricular arrhythmias. METHODS AND RESULTS: Three hundred fifty-three patients with arrhythmogenic right ventricular cardiomyopathy as per the 2010 Task Force Criteria with 6871 automatically processed 12-lead digital ECGs were included. The relationship between the electrocardiographic parameters and the risk of ventricular arrhythmias was assessed at 10 years from the first ECG. Electrocardiographic parameters were compared between the first contact ECG, the ECG at diagnosis, and the most recent ECG. Median time between the first and the latest ECG was 6 [interquartile range, 1–14] years. Reductions of QRS voltage, R-and T-wave amplitudes between the first, diagnostic, and the latest ECGs were observed across precordial and extremity leads. Mean QRS duration increased from 96 to 102 ms (P<0.001), terminal activation duration (V1) from 47 to 52 ms (P<0.001), and QTc from 419 to 432 ms (P<0.001). T-wave inversions in leads V3 to V6 and aVF at first ECG were associated with ventricular arrhythmias (adjusted hazard ratio [HRadj ][V3 ], 2.03 [95% CI, 1.23–3.34] and HRadj [aVF], 1.87 [95% CI, 1.13–3.08]). CONCLUSIONS: Depolarization and repolarization parameters evolved over time in patients with arrhythmogenic right ventricular cardiomyopathy, supporting the progressive nature of arrhythmogenic right ventricular cardiomyopathy. Electrocardiographic abnormalities may be detected before diagnosis and might, although not fulfilling the 2010 Task Force Criteria, be markers of early disease. T-wave inversion in leads V3 or aVF before diagnosis was associated with ventricular arrhythmias during follow-up.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
arrhythmogenic right ventricular cardiomyopathy, electrocardiography, longitudinal follow-up, natural course, prognosis, ventricular arrhythmia
in
Journal of the American Heart Association
volume
13
issue
16
article number
e031893
publisher
Wiley-Blackwell
external identifiers
  • pmid:39158567
  • scopus:85201990765
ISSN
2047-9980
DOI
10.1161/JAHA.123.031893
language
English
LU publication?
yes
id
b2aa642b-e335-4149-9869-74c4681bbc7d
date added to LUP
2024-10-28 12:43:42
date last changed
2025-07-08 10:52:37
@article{b2aa642b-e335-4149-9869-74c4681bbc7d,
  abstract     = {{<p>BACKGROUND: Electrocardiographic abnormalities are common in arrhythmogenic right ventricular cardiomyopathy and are included in the 2010 Task Force Criteria. Their time course, however, remains uncertain. In this retrospective observational study, we aimed to assess the long-term evolution of electrocardiographic characteristics and their relation to ventricular arrhythmias. METHODS AND RESULTS: Three hundred fifty-three patients with arrhythmogenic right ventricular cardiomyopathy as per the 2010 Task Force Criteria with 6871 automatically processed 12-lead digital ECGs were included. The relationship between the electrocardiographic parameters and the risk of ventricular arrhythmias was assessed at 10 years from the first ECG. Electrocardiographic parameters were compared between the first contact ECG, the ECG at diagnosis, and the most recent ECG. Median time between the first and the latest ECG was 6 [interquartile range, 1–14] years. Reductions of QRS voltage, R-and T-wave amplitudes between the first, diagnostic, and the latest ECGs were observed across precordial and extremity leads. Mean QRS duration increased from 96 to 102 ms (P&lt;0.001), terminal activation duration (V<sub>1</sub>) from 47 to 52 ms (P&lt;0.001), and QTc from 419 to 432 ms (P&lt;0.001). T-wave inversions in leads V<sub>3</sub> to V<sub>6</sub> and aVF at first ECG were associated with ventricular arrhythmias (adjusted hazard ratio [HR<sub>adj</sub> ][V<sub>3</sub> ], 2.03 [95% CI, 1.23–3.34] and HR<sub>adj</sub> [aVF], 1.87 [95% CI, 1.13–3.08]). CONCLUSIONS: Depolarization and repolarization parameters evolved over time in patients with arrhythmogenic right ventricular cardiomyopathy, supporting the progressive nature of arrhythmogenic right ventricular cardiomyopathy. Electrocardiographic abnormalities may be detected before diagnosis and might, although not fulfilling the 2010 Task Force Criteria, be markers of early disease. T-wave inversion in leads V<sub>3</sub> or aVF before diagnosis was associated with ventricular arrhythmias during follow-up.</p>}},
  author       = {{Svensson, Anneli and Jensen, Henrik Kjaerulf and Boonstra, Machteld J. and Tétreault-Langlois, Marianne and Dahlberg, Pia and Bundgaard, Henning and Christensen, Alex Hørby and Rylance, Rebecca T. and Svendsen, Jesper H. and Cadrin-Tourigny, Julia and Te Riele, Anneline S.J.M. and Platonov, Pyotr G.}},
  issn         = {{2047-9980}},
  keywords     = {{arrhythmogenic right ventricular cardiomyopathy; electrocardiography; longitudinal follow-up; natural course; prognosis; ventricular arrhythmia}},
  language     = {{eng}},
  number       = {{16}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of the American Heart Association}},
  title        = {{Natural Course of Electrocardiographic Features in Arrhythmogenic Right Ventricular Cardiomyopathy and Their Relation to Ventricular Arrhythmic Events}},
  url          = {{http://dx.doi.org/10.1161/JAHA.123.031893}},
  doi          = {{10.1161/JAHA.123.031893}},
  volume       = {{13}},
  year         = {{2024}},
}