{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T16:03:49Z","timestamp":1769011429652,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,9,6]],"date-time":"2015-09-06T00:00:00Z","timestamp":1441497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"UCLH\/UCL from the Department of Health's NIHR Biomedical Research Centres"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Epsilon Waves in ACM<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Epsilon waves are hallmark features of arrhythmogenic cardiomyopathy (ACM) but information about their clinical significance is variable. We evaluated epsilon wave prevalence, characteristics, and their clinical significance in an ACM population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Eighty\u2010six unselected patients fulfilling the 2010 Task Force criteria were enrolled. Seventy\u2010six of them were carriers of desmosomal mutations. All subjects were serially evaluated with standard 12\u2010lead ECG and 2\u2010dimensional echocardiography. Epsilon waves were evaluated in all precordial and inferior leads. Novel parameters assessed included their duration and precordial\/inferior lead extension. Twenty\u2010five subjects (29%) had epsilon waves that were present in lead V3 and beyond in 9, and in the inferior leads in 7. Epsilon waves were associated with right ventricular outflow tract (RVOT) (P = 0.001) but not RV posterior wall (P = 0.21), RV apex (P = 0.30), or left ventricular (P = 0.94) wall motion abnormalities. Patients with epsilon waves had increased RVOT diameter (P &lt; 0.0001). Extension of epsilon waves in lead V3 and beyond was associated with increased epsilon wave duration (P = 0.002) and RVOT diameter (P = 0.04). The duration of epsilon waves was positively correlated with RVOT diameter (r = 0.70, P = 0.0001). Epsilon waves were also associated with episodes of sustained ventricular tachycardia (P = 0.004) but not with heart failure (P = 0.41) or sudden cardiac death (P = 0.31).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Detection of epsilon waves on 12\u2010lead ECG reflects significant RVOT involvement, which was associated with episodes of sustained ventricular tachycardia but not sudden cardiac death.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.12755","type":"journal-article","created":{"date-parts":[[2015,7,16]],"date-time":"2015-07-16T16:48:48Z","timestamp":1437065328000},"page":"1204-1210","source":"Crossref","is-referenced-by-count":27,"title":["Clinical Significance of Epsilon Waves in Arrhythmogenic Cardiomyopathy"],"prefix":"10.1111","volume":"26","author":[{"given":"ALEXANDROS","family":"PROTONOTARIOS","sequence":"first","affiliation":[{"name":"Nikos Protonotarios Medical Centre Naxos  Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ARIS","family":"ANASTASAKIS","sequence":"additional","affiliation":[{"name":"1<sup>st<\/sup> Department of Cardiology University of Athens Medical School  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ADALENA","family":"TSATSOPOULOU","sequence":"additional","affiliation":[{"name":"Nikos Protonotarios Medical Centre Naxos  Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LOIZOS","family":"ANTONIADES","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nicosia General Hospital  Nicosia Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"EFSTATHIA","family":"PRAPPA","sequence":"additional","affiliation":[{"name":"2<sup>nd<\/sup> Department of Cardiology Evangelismos General Hospital  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PETROS","family":"SYRRIS","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science University College London and The Heart Hospital, University College London Hospitals Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DIMITRIOS","family":"TOUSOULIS","sequence":"additional","affiliation":[{"name":"1<sup>st<\/sup> Department of Cardiology University of Athens Medical School  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"WILLIAM J.","family":"McKENNA","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science University College London and The Heart Hospital, University College London Hospitals Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NIKOS","family":"PROTONOTARIOS","sequence":"additional","affiliation":[{"name":"Nikos Protonotarios Medical Centre Naxos  Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1995.tb06971.x"},{"key":"e_1_2_7_3_1","unstructured":"FontaineG GuiraudonF FrankR:Stimulation studies and epicardial mapping in ventricular tachycardia: Study of mechanisms and selection for surgery. 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