Heart failure & cardiomyopathies
The Diagnostic and Prognostic Value of the 12-Lead Electrocardiogram (ECG) in Arrhythmogenic Left Ventricular Cardiomyopathy
Authors' conclusion
In ALVC, ECG is a valuable diagnostic tool and may have a relevant prognostic role, since LFPB is a strong and independent predictor of MAE.
Study context
- Population
- Patients with arrhythmogenic left ventricular cardiomyopathy (ALVC)consecutive patients with ALVC (81.5% desmoplakin pathogenic/likely pathogenic variants)
- Participants
- 125 patients
- Comparison
- ECG, cardiac magnetic resonance and clinical predictors of major arrhythmic events (MAEs)
- Outcome
- ECG signs in ALVC
Methodological detailslogistic regression, Cox regression
- Logistic regression
- Cox regression
Main finding
As reported in the abstract
- Left posterior fascicular block (LPFB)
- 13.6%
- Pathological Q waves
- 26.4%
- R/S ratio in V1 ≥0.5
- 26.4%
- SV1 + RV6 ≤12 mm and RI + RII ≤8 mm
- 44%
- Normal ECG
- Fifteen (12%)
Further findings
Independent predictors of MAE (multivariable logistic regression)
| OR (95% CI) | ||
|---|---|---|
| LPFB | 4.7 (1.2–18.3) | |
| Syncope | 84.95 (14–496) | |
| Transmural late gadolinium enhancement | 9.95 (2.3–36) | |
| Right ventricular ejection fraction | 0.92 (0.87–0.97) | |
| 0.050.21520Odds ratio (log scale) |
Independent predictors of MAE in primary prevention (Cox regression)
| HR (95% CI) | ||
|---|---|---|
| LPFBPrimary prevention scenario | 3.98 (1.3–12.0) | |
| SyncopePrimary prevention scenario | 19.13 (5.8–63.0) | |
| Transmural late gadolinium enhancementPrimary prevention scenario | 10.57 (2.9–38.0) | |
| 0.050.21520Hazard ratio (log scale) |
MAE (sudden cardiac death, aborted sudden cardiac death, appropriate ICD shock)
- MAE occurred
- 35 patients (28%)
Predictive capability of model including the 4 variables
- Area under the curve
- 0.9
Original publication
The Diagnostic and Prognostic Value of the 12-Lead ECG in Arrhythmogenic Left Ventricular Cardiomyopathy. JACC Adv. Published 12 May 2025. doi:10.
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