Diagnostic value of signal-averaged electrocardiogram in arrythmogenic right ventricular cardiomyopathy patients

Waseem S Adam¹, Jamila K Adam¹ and Neil Hendricks²

¹Durban University of Technology, Faculty of Health Sciences, Department of Biomedical and Clinical technology, Durban, South Africa.

²Department of Cardiology, Groote Schuur Hospital, Cape Town, South Africa.

*Corresponding Author E-mail: Wnsr65@hotmail.com, adamjk@dut.ac.za; Tel: +27 31 373 5291; Fax: +27 31 373 5295

Accepted 12 July, 2013

Abstract

Arrythmogenic right ventricular cardiomyopathy (ARVC) is the leading cause of sudden cardiac death (SCD) in people aged <35 years. Accordingly, a successful early diagnosis of ARVC can be life saving. The aim of this study was to re-examine the diagnostic and clinical value of the signal-averaged electrocardiogram (SAECG) in patients with ARVC. This was a retrospective and prospective descriptive study conducted at Groote Schuur Hospital, Cape Town, South Africa.  Fifty one patients who had been diagnosed as either definite or possible ARVC using the international task force criteria 2010. They underwent SAECG to obtain RMS (root mean square), LAS (low amplitude signal) and fQRS (filtered QRS) recordings, which were then compared to the Groote Schuur Hospital protocol normal values, thus re-evaluating the importance of a SAECG in ARVC. Thirty six (71%) of the ARVC patients had an overall abnormal SAECGs, while 15 (29%) had normal SAECGs. Twenty one (58.3%) of the patients with overall abnormal SAECGs had definite ARVC while 15 (41.6%) had possible ARVC. SAECG can be a useful initial test before performing other procedures on the patient in order to meet the criteria for ARVC. An early abnormal SAECG would mean that the patient should be referred immediately for further tests as ARVC is a condition that should be treated early due to the risk of SCD.

Keywords: Arrythmogenic right ventricular cardiomyopathy (ARVC), signal-averaged electrocardiogram (SAECG).