Risk stratification of arrhythmogenic right ventricular cardiomyopathy based on signal averaged electrocardiograms

Ying Chieh Liao, Yenn Jiang Lin, Fa Po Chung, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Tze Fan Chao, Eric Chung, Ta Chuan Tuan, Jin Long Huang*, Jo Nan Liao, Yun Yu Chen, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background Signal averaged electrocardiogram (SAECG) is a specific and non-invasive tool useful for arrhythmogenic right ventricular cardiomyopathy (ARVC) diagnosis. However, its role in risk stratification of patients with ARVC remains largely undefined. Methods Sixty-four patients fulfilling Task Force ARVC criteria (mean age: 47 ± 14 years-old, 56% male, 50% definite ARVC) were enrolled. The baseline demographic, electrocardiographic, structural, and electrophysiological characteristics were collected. Patients with SAECG fulfilling all 3 Task Force criteria (3 + SAECG) were categorized into group 1, and those fulfilled 2 or less criterion were categorized into group 2. The study endpoints were unstable ventricular arrhythmia (VA), device detectable sustained fast VA (cycle lengths < 240 ms) and cardiovascular death. Results During a mean follow-up of 21 ± 20 months, 15 primary endpoints including 12 unstable VAs and 3 device-detected fast VAs were met. One patient died of electrical storm, and one patient underwent heart transplantation. The presence of 3 + SAECG predicted malignant events in all patients with definite and non-definite ARVC (p < 0.01, OR = 30.5, 95% CI = 2.5-373.7) and in patients with definite ARVC alone (p = 0.03, OR = 11.1, 95% CI = 1.3-93.9). Patients diagnosed with non-definite ARVC without 3 + SAECG were free from malignant events. Conclusions SAECG fulfilling all 3 Task Force criteria was an independent risk predictor of malignant events in ARVC patients. SAECG may play a valuable role in ARVC risk stratification.

Original languageEnglish
Pages (from-to)628-633
Number of pages6
JournalInternational Journal of Cardiology
Issue number3
StatePublished - 1 Jul 2014


  • Arrhythmogenic right ventricular cardiomyopathy
  • Signal-averaged electrocardiogram
  • Ventricular arrhythmia


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