[High-resolution electrocardiography in arrhythmogenic right ventricular disease]. / Electrocardiografia de alta resolução na doença ventricular direita arritmogênica.

ABSTRACT

PURPOSE: To determine the value of the high-resolution ECG for the differential diagnosis of arrhythmogenic right ventricular disease. METHODS: A group of 33 patients were studied, 16 males, mean age 34 +/- 16 years. All patients presented non-sustained or sustained or repetitive monomorphic ventricular tachycardias, with left bundle branch block morphology. The anatomic and functional evaluation of the right ventricle was made by a previous echocardiogram. No patient presented left ventricular or septal pathology. High-resolution ECG were obtained from a Corazonix-Predictor II program. In the filtered QRS was analyzed root mean square of the last 40ms QRS, the final lasting of the low amplitude signals < 40 microV and filtered QRS duration. Ten patients underwent to electrophysiological study with right ventricular mapping. RESULTS: The ventricular tachycardias was non-sustained in 18 patients, sustained in 8 and repetitive monomorphic in 7 patients. The echocardiogram was normal in 23 patients, and all these also presented normal high resolution ECG. Among the 10 patients with altered echocardiogram, 9 presented abnormal high-resolution ECG (sensibility 90%; specificity 100%; positive predictive value 100%; negative predictive value 96%; efficacy of the method to define the presence of manifested right ventricular pathology was 96%). Among the 10 patients with altered echocardiogram, 8 underwent to electrophysiological study. In all was detected an abnormal ventricular mapping and abnormal high-resolution ECG. CONCLUSION: The high-resolution ECG is an useful method to define a right ventricular manifested pathology in presence of arrhythmogenic disease of this cavity.