Special revelance of lead aVR in arrhythmogenic cardiomyopathy

According to a small study from Taiwan the relevance of lead aVR in arrhythmogernic cardiomyopathy was analysed. The precentage of epicardial scar in RVOT, right ventricular function and clinical or inducible ventricular fibrillation due to a QR pattern, a QS pattern und R pattern were described. Now, these findings should be analysed in a larger collective of patients with arrhythmogenic cardiomyopathy. Method: In a collective of 497 patients with arrhythmogenic cardiomyopathy (males 291 patients, mean age 46.2 years) were analysed. The QR pattern, the QS pattern and the R pattern were differentiated. The right ventricular function and risk were analysed. Results: Most cases (n=263) with arrhythmogenic cardiomyopathy have a moderately reduced right ventricular function with a QR pattern (52.9%) with large Q waves of ≥ 3 mm, a small R wave of ≤ 2 mm and T-wave inversions of ≤ 2 mm. The risk is moderately increased. Fewer patients (n=216) with a QS pattern (43.4%) and epsilon waves (n=199, 40.0%) not only associated with heart failure had right ventricular EF of about 35% and had a high risk of clinical or inducible ventricular fibrillation. Only 18 patients (3.6%), mostly associated with arrhythmogenic left ventricular cardiomyopathy, had a R pattern with severly reduced EF and the the highest risk of clinical or inducible ventricular fibrillation. Conclusions: The function of the right ventricle, and the risk of clinical und inducible VF can be predicted by QRS pattern in lead aVR. Lead aVR is of special importance and relevant in arrhythmogenic cardiomyopathy, especially QS and R pattern.