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Miscellaneous ECG 18

  1. Normal sinus rhythm
  2. Arrhythmogenic right ventricular dysplasia (ARVD) with epsilon waves

The classic ECG findings in arrhythmogenic right ventricular dysplasia are inverted T waves in the right precordial leads (V1-V3) with an “epsilon wave” just after the QRS in lead V1 representing early afterdepolarizations or “late potentials.” The epsilon wave is frequently described as having a “grassy knoll” appearance. This can also be seen on a signal averaged ECG. See the Cardiology Review section of LearnTheHeart.com for a complete review of arrhythmogenic right ventricular dysplasia including diagnostic criteria and treatment.

Related Topic Reviews: Arrhythmogenic Right Ventricular Dysplasia