{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:21:52Z","timestamp":1760145712603,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T00:00:00Z","timestamp":1724544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland","award":["3.8\/VI\/17"],"award-info":[{"award-number":["3.8\/VI\/17"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic disorder characterised by progressive fibrosis predominantly of the right ventricular (RV) myocardium, resulting in life-threatening arrhythmias and heart failure. The diagnosis is challenging due to a wide spectrum of clinical symptoms. The important role of ECG was covered in the current diagnostic criteria. The role of the epsilon wave (EW) is still under discussion. Aim: The aim of the study was to examine a potential association between the EW and late ventricular potentials (LPs) in ARVC patients (pts). The correlation between RV dilatation or dysfunction and LPs\/EW was also analysed. Methods: The ARVC group consisted of 81 pts (53 men, aged 20\u201378 years) fulfilling 2010 International Task Force Criteria. 12-lead ECG, LPs, Holter, and ECHO were performed in all pts. The presence of EW was analysed in ECG by 3 investigators. LPs were detected by signal-averaged ECG (SAECG). SAECG was considered positive for LPs when at least two of the three following criteria were met: (1) the filtered QRS duration (fQRS) \u2265 114 msec; (2) the duration of the final QRS fragment in which low-amplitude signals lower than 40 \u03bcV are recorded (LAS-40 &gt; 38 msec); and (3) the root mean square amplitude of the last 40 milliseconds of the fQRS complex (RMS-40 &lt; 20 \u03bcV). The results were compared with a reference group consisting of 53 patients with RV damage in the course of atrial septum defect (ASD) or Ebstein\u2019s Anomaly (EA). Results: In the ARVC group, a significant relationship was observed between the occurrence of EW and the presence of LPs. EW was more common in the LP+ than in the LP- patients (48.1% vs. 6.9%, p &lt; 0001; OR 12.5; 95% CI [2.691\u201358.063]). In ARVC pts, RVOT &gt; 36 mm, RVIT &gt; 41 mm, and RV S\u2019 &lt; 9 cm\/s were observed significantly more often in the LPs+ than in the LPs\u2212 group (OR [95% CI]: 8.3 [2.9\u20131.5], 6.4 [2.2\u201319.0] and 3.6 [1.1\u201312.2], respectively). In the ARVC group, any of fQRS &gt; 114 ms, LAS &gt; 38 ms, and RMS &lt; 20 \u03bcV were significantly more frequent in EW+ pts. In multivariate analysis, the independent factors of the EW were LAS-40 and RV S\u2019. In the LPs\u2212 subgroup, RVOT &gt; 36 mm was more frequent in ASD\/EA than in ARVC (70.4% vs. 25%, p = 0.002). Similarly, in the LPs\u2212 subgroup, RVIT &gt; 41 mm was encountered more frequently in ASD\/EA than in ARVC (85.2% vs. 48.3%, p = 0.004). Conclusions: In ARVC, there is an association between EW and LPs, with both probably resulting from the same process of fibrofatty substitution of the RV myocardium. Although RV dilatation is common in ASD and EA, it does not correlate with LPs.<\/jats:p>","DOI":"10.3390\/jcm13175038","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T03:32:01Z","timestamp":1724643121000},"page":"5038","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Correlation between Epsilon Wave and Late Potentials in Arrhythmogenic Right Ventricular Cardiomyopathy\u2014Do Late Potentials Define the Epsilon Wave?"],"prefix":"10.3390","volume":"13","author":[{"given":"Urszula","family":"Skrzypczy\u0144ska-Banasik","sequence":"first","affiliation":[{"name":"Cardinal Wyszynski National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6781-8198","authenticated-orcid":false,"given":"Olgierd","family":"Wo\u017aniak","sequence":"additional","affiliation":[{"name":"Cardinal Wyszynski National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8040-5109","authenticated-orcid":false,"given":"Ilona","family":"Kowalik","sequence":"additional","affiliation":[{"name":"Cardinal Wyszynski National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aneta","family":"Fronczak-Jakubczyk","sequence":"additional","affiliation":[{"name":"Cardinal Wyszynski National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina","family":"Borowiec","sequence":"additional","affiliation":[{"name":"Cardinal Wyszynski National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Cardinal Wyszynski National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3215-5085","authenticated-orcid":false,"given":"El\u017cbieta Katarzyna","family":"Biernacka","sequence":"additional","affiliation":[{"name":"Cardinal Wyszynski National Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1161\/CIRCULATIONAHA.115.017944","article-title":"Treatment of Arrhythmogenic Right Ventricular Cardiomyopathy\/Dysplasia: An International Task Force Consensus Statement","volume":"132","author":"Corrado","year":"2015","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1016\/S0735-1097(97)00332-X","article-title":"Spectrum of clinicopathologic manifestations of arrhythmogenic right ventricular cardiomyopathy\/dysplasia: A multicenter study","volume":"30","author":"Corrado","year":"1997","journal-title":"J. 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