The Experts below are selected from a list of 228 Experts worldwide ranked by ideXlab platform
Wojciech Kurdzielewicz - One of the best experts on this subject based on the ideXlab platform.
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Higher right precordial leads and Fontaine leads: the better detection of QRS fragmentation and Epsilon Wave in arrhythmogenic right ventricular dysplasia-cardiomyopathy
Kardiologia polska, 2012Co-Authors: Piotr Kukla, Marek Jastrzębski, Wojciech KurdzielewiczAbstract:Epsilon Waves (EW) in right precordial leads are reliable diagnostic electrocardiographic criteria of arrhythmogenic right ventricular dysplasia-cardiomyopathy (ARVD/C). The definition of EW remains difficult because within the QRS complex are inscribed notches or deflections called fragmentation of the QRS complex (f-QRS). The f-QRS at the beginning, on the top, and at the end of QRS complex (termed “pre-, top-, and postsilons”) was proposed as typical extended definition of EW. We described a 59-year-old female with ARVD with severe left ventricular involvement, ejection fraction — 23%. The standard 12-lead ECG showed QRS fragmentation in 7 leads. It can be a marker of ARVD with severe left ventricular disease. EW may be enhanced visually to 50–75% by following placing: the left arm should be placed on the xyphoid process and the right arm lead on the manubrium sternum, with the left leg in the location of V4 or V5 this is called the Fontaine bipolar precordial lead (F-ECG). Detection of right precordial f-QRS can be improved using higher right precordial leads (similar as in Brugada syndrome). The case we described reminds that EW could be enhancing by F-ECG leads and f-QRS by using higher right precodial leads.
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Zmodyfikowane ("wyższe") odprowadzenia przedsercowe prawokomorowe i odprowadzenia według modyfikacji Fontaine'a w rozpoznawaniu arytmogennej dysplazji/kardiomiopatii prawej komory Higher right precordial leads and Fontaine leads: the better detection
2012Co-Authors: Piotr Kukla, Wojciech KurdzielewiczAbstract:Epsilon Waves (EW) in right precordial leads are reliable diagnostic electrocardiographic criteria of arrhythmogenic right ventricular dysplasia-cardiomyopathy (ARVD/C). The definition of EW remains difficult because within the QRS complex are inscribed notches or deflections called fragmentation of the QRS complex (f-QRS). The f-QRS at the beginning, on the top, and at the end of QRS complex (termed “pre-, top-, and postsilons”) was proposed as typical extended definition of EW. We described a 59-year-old female with ARVD with severe left ventricular involvement, ejection fraction — 23%. The standard 12-lead ECG showed QRS fragmentation in 7 leads. It can be a marker of ARVD with severe left ventricular disease. EW may be enhanced visually to 50–75% by following placing: the left arm should be placed on the xyphoid process and the right arm lead on the manubrium sternum, with the left leg in the location of V 4 or V 5 this is called the Fontaine bipolar precordial lead (F-ECG). Detection of right precordial f-QRS can be improved using higher right precordial leads (similar as in Brugada syndrome). The case we described reminds that EW could be enhancing by F-ECG leads and f-QRS by using higher right precodial leads.
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zmodyfikowane wyzsze odprowadzenia przedsercowe prawokomorowe i odprowadzenia wedlug modyfikacji fontaine a w rozpoznawaniu arytmogennej dysplazji kardiomiopatii prawej komory higher right precordial leads and fontaine leads the better detection of q
2012Co-Authors: Piotr Kukla, Wojciech KurdzielewiczAbstract:Epsilon Waves (EW) in right precordial leads are reliable diagnostic electrocardiographic criteria of arrhythmogenic right ventricular dysplasia-cardiomyopathy (ARVD/C). The definition of EW remains difficult because within the QRS complex are inscribed notches or deflections called fragmentation of the QRS complex (f-QRS). The f-QRS at the beginning, on the top, and at the end of QRS complex (termed “pre-, top-, and postsilons”) was proposed as typical extended definition of EW. We described a 59-year-old female with ARVD with severe left ventricular involvement, ejection fraction — 23%. The standard 12-lead ECG showed QRS fragmentation in 7 leads. It can be a marker of ARVD with severe left ventricular disease. EW may be enhanced visually to 50–75% by following placing: the left arm should be placed on the xyphoid process and the right arm lead on the manubrium sternum, with the left leg in the location of V 4 or V 5 this is called the Fontaine bipolar precordial lead (F-ECG). Detection of right precordial f-QRS can be improved using higher right precordial leads (similar as in Brugada syndrome). The case we described reminds that EW could be enhancing by F-ECG leads and f-QRS by using higher right precodial leads.
Piotr Kukla - One of the best experts on this subject based on the ideXlab platform.
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Higher right precordial leads and Fontaine leads: the better detection of QRS fragmentation and Epsilon Wave in arrhythmogenic right ventricular dysplasia-cardiomyopathy
Kardiologia polska, 2012Co-Authors: Piotr Kukla, Marek Jastrzębski, Wojciech KurdzielewiczAbstract:Epsilon Waves (EW) in right precordial leads are reliable diagnostic electrocardiographic criteria of arrhythmogenic right ventricular dysplasia-cardiomyopathy (ARVD/C). The definition of EW remains difficult because within the QRS complex are inscribed notches or deflections called fragmentation of the QRS complex (f-QRS). The f-QRS at the beginning, on the top, and at the end of QRS complex (termed “pre-, top-, and postsilons”) was proposed as typical extended definition of EW. We described a 59-year-old female with ARVD with severe left ventricular involvement, ejection fraction — 23%. The standard 12-lead ECG showed QRS fragmentation in 7 leads. It can be a marker of ARVD with severe left ventricular disease. EW may be enhanced visually to 50–75% by following placing: the left arm should be placed on the xyphoid process and the right arm lead on the manubrium sternum, with the left leg in the location of V4 or V5 this is called the Fontaine bipolar precordial lead (F-ECG). Detection of right precordial f-QRS can be improved using higher right precordial leads (similar as in Brugada syndrome). The case we described reminds that EW could be enhancing by F-ECG leads and f-QRS by using higher right precodial leads.
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Zmodyfikowane ("wyższe") odprowadzenia przedsercowe prawokomorowe i odprowadzenia według modyfikacji Fontaine'a w rozpoznawaniu arytmogennej dysplazji/kardiomiopatii prawej komory Higher right precordial leads and Fontaine leads: the better detection
2012Co-Authors: Piotr Kukla, Wojciech KurdzielewiczAbstract:Epsilon Waves (EW) in right precordial leads are reliable diagnostic electrocardiographic criteria of arrhythmogenic right ventricular dysplasia-cardiomyopathy (ARVD/C). The definition of EW remains difficult because within the QRS complex are inscribed notches or deflections called fragmentation of the QRS complex (f-QRS). The f-QRS at the beginning, on the top, and at the end of QRS complex (termed “pre-, top-, and postsilons”) was proposed as typical extended definition of EW. We described a 59-year-old female with ARVD with severe left ventricular involvement, ejection fraction — 23%. The standard 12-lead ECG showed QRS fragmentation in 7 leads. It can be a marker of ARVD with severe left ventricular disease. EW may be enhanced visually to 50–75% by following placing: the left arm should be placed on the xyphoid process and the right arm lead on the manubrium sternum, with the left leg in the location of V 4 or V 5 this is called the Fontaine bipolar precordial lead (F-ECG). Detection of right precordial f-QRS can be improved using higher right precordial leads (similar as in Brugada syndrome). The case we described reminds that EW could be enhancing by F-ECG leads and f-QRS by using higher right precodial leads.
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zmodyfikowane wyzsze odprowadzenia przedsercowe prawokomorowe i odprowadzenia wedlug modyfikacji fontaine a w rozpoznawaniu arytmogennej dysplazji kardiomiopatii prawej komory higher right precordial leads and fontaine leads the better detection of q
2012Co-Authors: Piotr Kukla, Wojciech KurdzielewiczAbstract:Epsilon Waves (EW) in right precordial leads are reliable diagnostic electrocardiographic criteria of arrhythmogenic right ventricular dysplasia-cardiomyopathy (ARVD/C). The definition of EW remains difficult because within the QRS complex are inscribed notches or deflections called fragmentation of the QRS complex (f-QRS). The f-QRS at the beginning, on the top, and at the end of QRS complex (termed “pre-, top-, and postsilons”) was proposed as typical extended definition of EW. We described a 59-year-old female with ARVD with severe left ventricular involvement, ejection fraction — 23%. The standard 12-lead ECG showed QRS fragmentation in 7 leads. It can be a marker of ARVD with severe left ventricular disease. EW may be enhanced visually to 50–75% by following placing: the left arm should be placed on the xyphoid process and the right arm lead on the manubrium sternum, with the left leg in the location of V 4 or V 5 this is called the Fontaine bipolar precordial lead (F-ECG). Detection of right precordial f-QRS can be improved using higher right precordial leads (similar as in Brugada syndrome). The case we described reminds that EW could be enhancing by F-ECG leads and f-QRS by using higher right precodial leads.
Etienne Delacretaz - One of the best experts on this subject based on the ideXlab platform.
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High risk of heart failure associated with desmoglein-2 mutations compared to plakophilin-2 mutations in arrhythmogenic right ventricular cardiomyopathy/dysplasia
European Journal of Heart Failure, 2019Co-Authors: Alexis Hermida, Véronique Fressart, Erwan Donal, Françoise Hidden-lucet, Vincent Probst, Jean-claude Deharo, Philippe Chevalier, Didier Klug, Nicolas Mansencal, Etienne DelacretazAbstract:BACKGROUND: Previous studies suggested that genetic status affects the clinical course of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) patients. The aim of this study was to compare the outcome of desmoglein-2 (DSG2) mutation carriers to those who carry the plakophilin-2 (PKP2) mutation, the most common ARVC/D-associated gene. METHODS AND RESULTS: Consecutive ARVC/D patients carrying a pathogenic mutation in PKP2 or DSG2 were selected from a national ARVC/D registry. The cumulative freedom from sustained ventricular arrhythmia and cardiac transplantation/death from heart failure (HF) during follow-up was assessed, compared between PKP2 and DSG2, and predictors for ventricular arrhythmia and HF events determined. Overall, 118 patients from 78 families were included: 27 (23%) carried a DSG2 mutation and 91 (77%) a PKP2 mutation. There were no significant differences between DSG2 and PKP2 mutation carriers concerning gender, proband status, age at diagnosis, T-Wave inversion, or right ventricular dysfunction at baseline. DSG2 patients displayed more frequent Epsilon Wave (37% vs. 17%, P = 0.048) and left ventricular dysfunction at diagnosis (54% vs. 10%, P < 0.001). During a median follow-up of 5.6 years (2.5-16), DSG2 and PKP2 mutation carriers displayed a similar risk of sustained ventricular arrhythmia (log-rank P = 0.20), but DSG2 mutation carriers were at higher risk of transplantation/HF-related death (log-rank P < 0.001). The presence of a DSG2 mutation vs. PKP2 mutation was a predictor of transplantation/HF-related death in univariate Cox analysis (P = 0.0005). CONCLUSIONS: In this multicentre cohort, DSG2 mutation carriers were found to be at high risk of end-stage HF compared to PKP2 mutation carriers, supporting careful haemodynamic monitoring of these patients. The benefit of early HF treatment needs to be assessed in DSG2 carriers.
Ming Hsiung Hsieh - One of the best experts on this subject based on the ideXlab platform.
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an Epsilon Wave in arrhythmogenic right ventricular cardiomyopathy dysplasia
International Journal of Cardiology, 2007Co-Authors: Chun Chi You, Yuan Teng Tseng, Ming Hsiung HsiehAbstract:A 53-year-old male presented to our emergency department with a sudden onset of ventricular tachycardia with left bundle branch block and right axis deviation. After the tachyarrhythmia converting to sinus rhythm, the ECG displayed sinus rhythm with a typical Epsilon Wave in leads V1 and V2. Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) was suspected. The Epsilon Wave is the most specific hallmark for the diagnosis of ARVD/C, although it is insensitive. For the management of these patients, antiarrhythmic medications appear to be effective. However, implantable cardioverter defibrillators are the only reliable treatment to prevent sudden cardiac death.
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An Epsilon Wave in arrhythmogenic right ventricular cardiomyopathy/dysplasia
International journal of cardiology, 2007Co-Authors: Chun Chi You, Yuan Teng Tseng, Ming Hsiung HsiehAbstract:A 53-year-old male presented to our emergency department with a sudden onset of ventricular tachycardia with left bundle branch block and right axis deviation. After the tachyarrhythmia converting to sinus rhythm, the ECG displayed sinus rhythm with a typical Epsilon Wave in leads V1 and V2. Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) was suspected. The Epsilon Wave is the most specific hallmark for the diagnosis of ARVD/C, although it is insensitive. For the management of these patients, antiarrhythmic medications appear to be effective. However, implantable cardioverter defibrillators are the only reliable treatment to prevent sudden cardiac death.
Adrian Baranchuk - One of the best experts on this subject based on the ideXlab platform.
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Arrhythmogenic right ventricular dysplasia/cardiomyopathy: an electrocardiogram-based review.
Europace : European pacing arrhythmias and cardiac electrophysiology : journal of the working groups on cardiac pacing arrhythmias and cardiac cellula, 2017Co-Authors: José Nunes De Alencar Neto, Adrian Baranchuk, Antoni Bayes-genis, Antoni Bayés De LunaAbstract:Arrhythmogenic right ventricular dysplasia or cardiomyopathy (ARVD/C) is a pathologic condition where the right ventricle is partially or totally replaced by fatty and fibrous tissue. The electrocardiogram (ECG) has a central role for diagnosis since it comprises two major and two minor criteria in the diagnostic criteria published by the Task 1 Force, although it is not 100% necessary to make a final diagnosis, because around 10% of patients with ARVD/C present with a normal ECG. In this article, we review the 12-lead electrocardiographic findings of patients with ARVD/C. ECG criteria observed during depolarization [prolonged terminal activation duration, Epsilon Wave, partial right bundle branch block (RBBB) and advanced RBBB of peripheral origin with characteristic ECG patterns] and repolarization abnormalities, (negative T Waves) are reviewed in detail. More common ventricular arrhythmias and risk of sudden death, and how to use the surface ECG to stratify the risk, are part of our final comments.
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Epsilon Wave in the 12-Lead Electrocardiogram: Is Its Frequency Underestimated?
Revista espanola de cardiologia (English ed.), 2015Co-Authors: Javier García-niebla, Adrian Baranchuk, Antonio Bayés De LunaAbstract:Javier Garcia-Niebla,* Adrian Baranchuk, and Antonio Bayes de Luna a Centro de Salud Valle del Golfo, Servicios Sanitarios del Area de Salud de El Hierro, Frontera-El Hierro, Sta. Cruz de Tenerife, Spain Heart Rhythm Service, Kingston General Hospital, Queen’s University, Kingston, Ontario, Canada c Institut Catala de Ciencies Cardiovasculars, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Ablation-induced Epsilon Wave
Heart rhythm, 2012Co-Authors: Jane Caldwell, Damian P. Redfearn, Pablo A. Chiale, Adrian BaranchukAbstract:1547-5271/$-see front matter B 2013 Heart Rhythm Society. All rights reserved. Epsilon Waves (low-amplitude deflections between the QRS and the T-Wave onset) in the right precordial ECG leads are a major diagnostic criterion for arrhythmogenic right ventricular cardiomyopathy (ARVC). Here we present a unique case of de novo Epsilon Wave formation occurring after catheter ablation. A 23-year-old ARVC patient with a pathologic DSP mutation (position c.1292dupA) was admitted with repeated