Medtronic Plc, Bakken Research Center, 11 Maastricht, The Netherlands.
West Yorkshire Arrhythmia Service, Leeds General Infirmary, Great George Street, Leeds LS1?3EX, UK.
Europace. 2018 Jun 1;20(FI1):f13-f19. doi: 10.1093/europace/eux124.
The identification of arrhythmogenic right ventricular dysplasia (ARVD) from 12-channel standard electrocardiogram (ECG) is challenging. High density ECG data may identify lead locations and criteria with a higher sensitivity.
Eighty-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 normalized ECG cycles. The channels with the 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.
Multichannel recordings, as in body surface mapping, add 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.
从 12 导联标准心电图（ECG）中识别致心律失常性右室心肌病（ARVD）具有挑战性。高密度 ECG 数据可能会确定具有更高灵敏度的导联位置和标准。
对诊断为 ARVD 和对照组的患者进行 80 通道 ECG 记录，并通过 QRS 和 T 波的幅度和积分测量以及标准化 ECG 周期形状差异的测量（平均轮廓宽度）进行量化。在靠近右心室壁的第三肋间隙的导联中，ARVD 患者与对照组之间的可分离性最佳。与对照组相比，这些导联的 P 波差异明显，QRS 和 T 波也存在预期差异。
与体表映射中的多通道记录相比，从心电图中诊断 ARVD 的可靠性增加有限。然而，将心电图电极重新定位到高前位置可以提高 ARVD 中心电图变化的识别能力。此外，P 波幅度增加似乎与 ARVD 有关。
