ArticleJournal of arrhythmia2026
Diagnostic Accuracy of Electrocardiographic Criteria in Differentiating Arrhythmogenic Right Ventricular Cardiomyopathy From Idiopathic Outflow Tract Ventricular Arrhythmia: A Systematic Review and Meta-Analysis.
Article in Journal of arrhythmia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
Background: Differentiating arrhythmogenic right ventricular cardiomyopathy (ARVC) from idiopathic outflow tract ventricular arrhythmias (OT VA) remains a challenge due to overlapping electrocardiographic (ECG) features. However, their pathophysiology and prognosis differ. Given the limited accessibility of advanced imaging, ECG parameters could facilitate early diagnosis. This review and meta-analysis evaluate the diagnostic accuracy of ECG parameters in distinguishing ARVC from OT VA. Methods: A systematic database search was conducted from inception to March 2025. Observational studies assessing ECG markers for differentiating ARVC from OT VA in adults were included. Diagnostic accuracy metrics (sensitivity, specificity, diagnostic odds ratio, and area under the receiver operating characteristic curve [AUC]) were synthesized using a bivariate random-effects model. Risk of bias was assessed using the QUADAS-2 tool. Results: Ten studies enrolling 723 patients were included. T-wave inversion in V1-V3 was the most commonly assessed parameter, with a pooled sensitivity of 0.55 and specificity of 0.88 (AUC = 0.798). Epsilon waves demonstrated low sensitivity (0.12) but high specificity (0.98). Among depolarization-based parameters, QRS duration in V1-V3 (AUC = 0.832) and the ratio of QRS duration in precordial leads (AUC = 0.938) demonstrated strong diagnostic performance. S-wave upstroke and terminal activation delay also showed high specificity (0.95) but moderate sensitivity. Conclusion: Several ECG parameters, particularly depolarization-based parameters, exhibit high specificity and moderate sensitivity in differentiating ARVC from OT VA. These findings support the use of ECG as a reliable and accessible diagnostic tool, particularly in settings without advanced imaging. A multi-marker ECG approach may enhance early recognition of patients with suspected ARVC.
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