What is arrhythmogenic right ventricular dysplasia ARVD?

Arrhythmogenic right ventricular dysplasia / cardiomyopathy (ARVD/C) is a rare familial disorder that may cause ventricular tachycardia and sudden cardiac death in young, apparently healthy individuals. The clinical hallmark of the disease is ventricular arrhythmias, arising predominantly from the right ventricle.

What does an epsilon wave indicate?

Answer. The epsilon wave is a specific ECG finding for arrhythmogenic right ventricular cardiomyopathy (ARVC), which is the second most common cause of unexpected sudden cardiac death in young people after hypertrophic obstructive cardiomyopathy.

How serious is ARVD?

Patients with ARVD often have arrhythmias (abnormal heart rhythms), which can increase the risk of sudden cardiac arrest or death.

Are Epsilon waves bad?

The presence of ε waves on the S-12-ECG reflects significant RV outflow tract involvement, which is associated with episodes of sustained VT but not with sudden cardiac death. It is possible that lead location of the ε wave may have prognostic significance. Lead aVR ε wave may be a marker of poor prognosis [23,25].

Is ARVD curable?

Your doctor will check your symptoms and test results to see if you need an ICD. Heart transplant. In rare cases, a heart transplant may be needed if the damage to the heart is severe. This is currently the only known cure for ARVD.

What are the symptoms of ARVD?

Symptoms of ARVC/D include a strong or irregular heart beat (palpitations), chest pain, or shortness of breath. Symptoms can include palpitations, lightheadedness, fainting, or even cardiac arrest. Episodes can occur at any time, but are often associated with physical exertion.

Can you exercise with ARVD?

For now, it is clear that competitive sports should be avoided in patients with ARVC. Participation in moderate- to high-intensity recreational sports is also discouraged. The recommendations for activity restrictions in asymptomatic gene carriers (genotype positive/phenotype negative) have less data.

What is the normal range for ECG?

Normal intervals Normal range 120 – 200 ms (3 – 5 small squares on ECG paper). QRS duration (measured from first deflection of QRS complex to end of QRS complex at isoelectric line). Normal range up to 120 ms (3 small squares on ECG paper).

Which is the best way to diagnose ARVD?

Histological diagnosis, either via endomyocardial biopsy or at autopsy, provides a definitive diagnosis but is impractical, and for those patients diagnosed at post-mortem… far too late! Patients with ARVD are considered to be at high risk of sudden death if they have any of the following:

What are the signs and symptoms of ARVC?

Epsilon wave and prolonged TAD strongly suggests ARVC. Low limb lead voltage. Patients with ARVC display frequent premature ventricular contractions (PVC), which may advance to monomorphic ventricular tachycardia (VT). Ventricular tachycardia in ARVC has LBBB morphology, with negative T-waves in V1 through V4.

What causes the epsilon wave in ARVD / C?

Epsilon waves are the most characteristic finding in arrhythmogenic right ventricular dysplasia (ARVD/C). Here myocytes are replaced with fat, producing islands of viable myocytes in a sea of fat. This causes a delay in excitation of some of the myocytes of the right ventricle and causes the little wiggles seen during the ST segment of the ECG.

Why are myocytes replaced by Fat in ARVD?

Epsilon wave in V1 due to RV conduction delay Epsilon waves are the most specific and characteristic finding in arrhythmogenic right ventricular dysplasia (ARVD). In ARVD, myocytes are replaced by fat, producing islands of viable myocytes in a sea of fat.