56-74: Diagnostic value of the electrocardiogram in arrhythmogenic left ventricular cardiomyopathy

Background: Arrhythmogenic cardiomyopathy (AC) primarily affects the right ventricle but left ventricular (LV) involvement is common. Nevertheless, 12-lead electrocardiography characteristics of LV involvement have not been studied. Our aim is to assess ECG features of LV involvement in AC. Methods: In a cohort of 51 patients with AC (39 males; mean age 47.6 ± 15.2 years) there were 32 patients with LV involvement (62 %). The association of depolarization and repolarization ECG abnormalities were analysed in patients with or without LV involvement in a cross-sectional design study. Results: As appreciated in the table, T wave inversion in V4-V6 was not associated with the presence of LV affection in the echocardiogram. QRS tended to be wider, and more fragmentated in patients with exclusive right ventricular disease compared to those with LV involvement. We found no ECG feature with clear ability to predict LV disease. Conclusion: Inferior and lateral ECG leads abnormalities do not predict the presence of LV involvement in patients with AC, against previously published diagnostic criteria. Moreover, QRS was slightly wider and more fragmented in V1-V3 in patients with exclusive right ventricular affection, suggesting a possible predominant left ventricular disease in cases of biventricular dysplasia.