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Epsilon Wave

Epsilon wave

Arrhythmogenic Right Ventricular Dysplasia
ECG and Epsilon Wave (ε)

Arrhythmogenic Right Ventricular Dysplasia

Arrhythmogenic right ventricular dysplasia (ARVD), cardiomyopathy

It is a congenital genetic disorder affecting the right ventricle

It leads to fibrosis (scarring) and fatty replacement of the right ventricle
The right ventricle then has altered electrical properties (action potential)

Arrhythmogenic Right Ventricular Dysplasia (ARVD)

It is an arrhythmic substrate where arrhythmias frequently occur:

It is often classified among cardiomyopathies
On ECG, it creates a characteristic epsilon wave

ECG and Epsilon Wave (ε)

ECG epsilon wave and ARVD

Epsilon wave is a small positive deflection at the end of the QRS complex.
It is seen in the leads that "look at" the right ventricle. (V1-V3)
About 30% of patients with ARVD have the epsilon wave

ECG V1 epsilon wave Arrhythmogenic right ventricular dysplasia (ARVD)

Arrhythmogenic Right Ventricular Dysplasia

Epsilon wave (V1)
Negative T waves

ECG V1 epsilon wave Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)

Arrhythmogenic Right Ventricular Cardiomyopathy

Epsilon wave (V1)
Negative T waves

ECG V1 epsilon wave Arrhythmogenic Right Ventricular Disease

Arrhythmogenic Right Ventricular Disease

Epsilon wave (V3)
Negative T waves

ECG V1-V3 epsilon wave Arrhythmogenic Right Ventricular Dysplasia with fibrosis

Arrhythmogenic Right Ventricular Dysplasia

Epsilon wave (V1-V3)
Negative T waves

ECG epsilon wave and ARVD

Arrhythmogenic Right Ventricular Dysplasia

Epsilon wave (V1)
Negative T wave

ECG Arrhythmogenic Right Ventricular Cardiomyopathy, Dysplasia, Disease, and epsilon wave

Epsilon Wave and Arrhythmogenic Right Ventricular Dysplasia

Arrhythmogenic Right Ventricular Dysplasia

Epsilon wave (in all leads)
Negative T waves (V1-V3), also V4-6
Hypertrophy and overload of the right ventricle

R/S ratio (V1) ≥ 1
Descendant ST segment and Negative T waves (V1-4) (II, III, aVF)

Sources

ECG from Basics to Essentials Step by Step
litfl.com
ecgwaves.com
metealpaslan.com
medmastery.com
uptodate.com
ecgpedia.org
wikipedia.org
Strong Medicine
Understanding Pacemakers

Epsilon Wave

Epsilon wave

Arrhythmogenic Right Ventricular Dysplasia
ECG and Epsilon Wave (ε)

Arrhythmogenic Right Ventricular Dysplasia

It is a congenital genetic disorder affecting the right ventricle

It leads to fibrosis (scarring) and fatty replacement of the right ventricle
The right ventricle then has altered electrical properties (action potential)

Arrhythmogenic Right Ventricular Dysplasia (ARVD)

It is an arrhythmic substrate where arrhythmias frequently occur:

It is often classified among cardiomyopathies
On ECG, it creates a characteristic epsilon wave

Arrhythmogenic right ventricular dysplasia (ARVD), cardiomyopathy

ECG and Epsilon Wave (ε)

Epsilon wave is a small positive deflection at the end of the QRS complex.
It is seen in the leads that "look at" the right ventricle. (V1-V3)
About 30% of patients with ARVD have the epsilon wave

ECG epsilon wave and ARVD

ECG V1 epsilon wave Arrhythmogenic right ventricular dysplasia (ARVD)

Arrhythmogenic Right Ventricular Dysplasia

Epsilon wave (V1)
Negative T waves

ECG V1 epsilon wave Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)

Arrhythmogenic Right Ventricular Cardiomyopathy

Epsilon wave (V1)
Negative T waves

ECG V1 epsilon wave Arrhythmogenic Right Ventricular Disease

Arrhythmogenic Right Ventricular Disease

Epsilon wave (V3)
Negative T waves

ECG V1-V3 epsilon wave Arrhythmogenic Right Ventricular Dysplasia with fibrosis

Arrhythmogenic Right Ventricular Dysplasia

Epsilon wave (V1-V3)
Negative T waves

ECG epsilon wave and ARVD

Arrhythmogenic Right Ventricular Dysplasia

Epsilon wave (V1)
Negative T wave

ECG Arrhythmogenic Right Ventricular Cardiomyopathy, Dysplasia, Disease, and epsilon wave

Epsilon Wave and Arrhythmogenic Right Ventricular Dysplasia

Arrhythmogenic Right Ventricular Dysplasia

Epsilon wave (in all leads)
Negative T waves (V1-V3), also V4-6
Hypertrophy and overload of the right ventricle

R/S ratio (V1) ≥ 1
Descendant ST segment and Negative T waves (V1-4) (II, III, aVF)

Sources

ECG from Basics to Essentials Step by Step
litfl.com
ecgwaves.com
metealpaslan.com
medmastery.com
uptodate.com
ecgpedia.org
wikipedia.org
Strong Medicine
Understanding Pacemakers