U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Epsilon wave

MedGen UID:
1815063
•Concept ID:
C5706157
•
Finding
HPO: HP:0034304

Definition

An electric signal of depolarization observed between the end of the QRS complex and the beginning of the T wave. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVEpsilon wave

Conditions with this feature

Arrhythmogenic right ventricular dysplasia 9
MedGen UID:
373205
•Concept ID:
C1836906
•
Disease or Syndrome
Arrhythmogenic right ventricular cardiomyopathy (ARVC) – previously referred to as arrhythmogenic right ventricular dysplasia (ARVD) – is characterized by progressive fibrofatty replacement of the myocardium that predisposes to ventricular tachycardia and sudden death in young individuals and athletes. It primarily affects the right ventricle, and it may also involve the left ventricle. The presentation of disease is highly variable even within families, and some affected individuals may not meet established clinical criteria. The mean age at diagnosis is 31 years (±13; range: 4-64 years).
See: Condition Record
Arrhythmogenic right ventricular dysplasia 10
MedGen UID:
347543
•Concept ID:
C1857777
•
Disease or Syndrome
Arrhythmogenic right ventricular cardiomyopathy (ARVC) – previously referred to as arrhythmogenic right ventricular dysplasia (ARVD) – is characterized by progressive fibrofatty replacement of the myocardium that predisposes to ventricular tachycardia and sudden death in young individuals and athletes. It primarily affects the right ventricle, and it may also involve the left ventricle. The presentation of disease is highly variable even within families, and some affected individuals may not meet established clinical criteria. The mean age at diagnosis is 31 years (±13; range: 4-64 years).
See: Condition Record
Arrhythmogenic right ventricular dysplasia 10
Arrhythmogenic right ventricular dysplasia 9

Recent clinical studies

Etiology

Clinical Features, Genetic Findings, and Risk Stratification in Arrhythmogenic Right Ventricular Cardiomyopathy: Data From a Brazilian Cohort.
Olivetti NQS, Sacilotto L, Wulkan F, D'Arezzo Pessente G, Lombardi Peres de Carvalho M, Moleta D, Tessariol Hachul D, Veronese P, Hardy C, Pisani C, Wu TC, Vieira MLC, de França LA, de Souza Freitas M, Rochitte CE, Bueno SC, Bastos Lovisi V, Krieger JE, Scanavacca M, da Costa Pereira A, da Costa Darrieux F
Circ Arrhythm Electrophysiol 2023 Feb;16(2):e011391. Epub 2023 Jan 31 doi: 10.1161/CIRCEP.122.011391. PMID: 36720007
Clinical features and arrhythmic complications of patients with pediatric-onset arrhythmogenic right ventricular dysplasia.
Sevinç Şengül F, Tunca Şahin G, Özgür S, Kafalı HC, Akıncı O, Güzeltaş A, Ergül Y
Anatol J Cardiol 2019 Aug;22(2):60-67. doi: 10.14744/AnatolJCardiol.2019.56985. PMID: 31375646Free PMC Article
Arrhythmogenic right ventricular dysplasia/cardiomyopathy: an electrocardiogram-based review.
Nunes de Alencar Neto J, Baranchuk A, Bayés-Genís A, Bayés de Luna A
Europace 2018 Jun 1;20(FI1):f3-f12. doi: 10.1093/europace/eux202. PMID: 29272363
Changes in follow-up ECG and signal-averaged ECG in patients with arrhythmogenic right ventricular cardiomyopathy.
Bae MH, Kim JH, Jang SY, Park SH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC
Pacing Clin Electrophysiol 2014 Apr;37(4):430-8. Epub 2013 Oct 25 doi: 10.1111/pace.12285. PMID: 24164254
Arrhythmogenic right ventricular dysplasia/cardiomyopathy. A review and update.
Francés RJ
Int J Cardiol 2006 Jun 28;110(3):279-87. Epub 2005 Aug 15 doi: 10.1016/j.ijcard.2005.07.004. PMID: 16099519

Diagnosis

Epsilon Waves as an Extreme Form of Depolarization Delay: Focusing on the Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia.
Platonov PG, Svensson A
Curr Cardiol Rev 2021;17(1):17-23. doi: 10.2174/1573403X16666200810105029. PMID: 32778035Free PMC Article
Epsilon waves: Milestones in the discovery and progress.
Li GL, Saguner AM, Fontaine GH, Frank R
Ann Noninvasive Electrocardiol 2018 Nov;23(6):e12571. Epub 2018 Jul 5 doi: 10.1111/anec.12571. PMID: 29978588Free PMC Article
Arrhythmogenic right ventricular dysplasia/cardiomyopathy: an electrocardiogram-based review.
Nunes de Alencar Neto J, Baranchuk A, Bayés-Genís A, Bayés de Luna A
Europace 2018 Jun 1;20(FI1):f3-f12. doi: 10.1093/europace/eux202. PMID: 29272363
The electrocardiographic manifestations of arrhythmogenic right ventricular dysplasia.
Zhang L, Liu L, Kowey PR, Fontaine GH
Curr Cardiol Rev 2014 Aug;10(3):237-45. doi: 10.2174/1573403x10666140514102928. PMID: 24827798Free PMC Article
Ablation-induced epsilon wave.
Caldwell J, Redfearn D, Chiale PA, Baranchuk A
Heart Rhythm 2013 Nov;10(11):1737-8. Epub 2012 Aug 29 doi: 10.1016/j.hrthm.2012.08.038. PMID: 23102627

Therapy

Epsilon Wave Masked by ST-Segment Elevation After Cardioversion From Sustained Ventricular Tachycardia: An Exceptional Manifestation of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy.
Kim S, Lee JH, Nho WY, Kim H
J Emerg Med 2022 Feb;62(2):254-259. Epub 2022 Jan 17 doi: 10.1016/j.jemermed.2021.10.033. PMID: 35058095
Epsilon wave on an electronic loop in a case of arrhythmogenic right ventricular dysplasia with myocarditis: an updated definition of the Epsilon wave.
Fontaine GH, Duthoit G, Li G, Andreoletti L, Gandjbakhch E, Frank R
Europace 2017 Jul 1;19(7):1084-1090. doi: 10.1093/europace/euw320. PMID: 28062531
Ablation-induced epsilon wave.
Caldwell J, Redfearn D, Chiale PA, Baranchuk A
Heart Rhythm 2013 Nov;10(11):1737-8. Epub 2012 Aug 29 doi: 10.1016/j.hrthm.2012.08.038. PMID: 23102627
The presence of giant epsilon waves in a patient with arrhythmogenic right ventricular cardiomyopathy.
Bao H, Hong K, Li J, Cheng X
Ann Noninvasive Electrocardiol 2012 Jul;17(3):277-9. doi: 10.1111/j.1542-474X.2012.00519.x. PMID: 22816547Free PMC Article
Clinical study of 39 Chinese patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy.
Ma KJ, Li N, Wang HT, Chu JM, Fang PH, Yao Y, Ma J, Hua W, Zhang S, Wang FZ, Li Z, Pu JL
Chin Med J (Engl) 2009 May 20;122(10):1133-8. PMID: 19493458

Prognosis

Clinical Features, Genetic Findings, and Risk Stratification in Arrhythmogenic Right Ventricular Cardiomyopathy: Data From a Brazilian Cohort.
Olivetti NQS, Sacilotto L, Wulkan F, D'Arezzo Pessente G, Lombardi Peres de Carvalho M, Moleta D, Tessariol Hachul D, Veronese P, Hardy C, Pisani C, Wu TC, Vieira MLC, de França LA, de Souza Freitas M, Rochitte CE, Bueno SC, Bastos Lovisi V, Krieger JE, Scanavacca M, da Costa Pereira A, da Costa Darrieux F
Circ Arrhythm Electrophysiol 2023 Feb;16(2):e011391. Epub 2023 Jan 31 doi: 10.1161/CIRCEP.122.011391. PMID: 36720007
Clinical features and arrhythmic complications of patients with pediatric-onset arrhythmogenic right ventricular dysplasia.
Sevinç Şengül F, Tunca Şahin G, Özgür S, Kafalı HC, Akıncı O, Güzeltaş A, Ergül Y
Anatol J Cardiol 2019 Aug;22(2):60-67. doi: 10.14744/AnatolJCardiol.2019.56985. PMID: 31375646Free PMC Article
Arrhythmogenic right ventricular dysplasia/cardiomyopathy: an electrocardiogram-based review.
Nunes de Alencar Neto J, Baranchuk A, Bayés-Genís A, Bayés de Luna A
Europace 2018 Jun 1;20(FI1):f3-f12. doi: 10.1093/europace/eux202. PMID: 29272363
Genotype-phenotype relationship in patients with arrhythmogenic right ventricular cardiomyopathy caused by desmosomal gene mutations: A systematic review and meta-analysis.
Xu Z, Zhu W, Wang C, Huang L, Zhou Q, Hu J, Cheng X, Hong K
Sci Rep 2017 Jan 25;7:41387. doi: 10.1038/srep41387. PMID: 28120905Free PMC Article
Arrhythmogenic right ventricular dysplasia/cardiomyopathy. A review and update.
Francés RJ
Int J Cardiol 2006 Jun 28;110(3):279-87. Epub 2005 Aug 15 doi: 10.1016/j.ijcard.2005.07.004. PMID: 16099519

Clinical prediction guides

Clinical Features, Genetic Findings, and Risk Stratification in Arrhythmogenic Right Ventricular Cardiomyopathy: Data From a Brazilian Cohort.
Olivetti NQS, Sacilotto L, Wulkan F, D'Arezzo Pessente G, Lombardi Peres de Carvalho M, Moleta D, Tessariol Hachul D, Veronese P, Hardy C, Pisani C, Wu TC, Vieira MLC, de França LA, de Souza Freitas M, Rochitte CE, Bueno SC, Bastos Lovisi V, Krieger JE, Scanavacca M, da Costa Pereira A, da Costa Darrieux F
Circ Arrhythm Electrophysiol 2023 Feb;16(2):e011391. Epub 2023 Jan 31 doi: 10.1161/CIRCEP.122.011391. PMID: 36720007
Epsilon Waves as an Extreme Form of Depolarization Delay: Focusing on the Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia.
Platonov PG, Svensson A
Curr Cardiol Rev 2021;17(1):17-23. doi: 10.2174/1573403X16666200810105029. PMID: 32778035Free PMC Article
Clinical features and arrhythmic complications of patients with pediatric-onset arrhythmogenic right ventricular dysplasia.
Sevinç Şengül F, Tunca Şahin G, Özgür S, Kafalı HC, Akıncı O, Güzeltaş A, Ergül Y
Anatol J Cardiol 2019 Aug;22(2):60-67. doi: 10.14744/AnatolJCardiol.2019.56985. PMID: 31375646Free PMC Article
Arrhythmogenic right ventricular dysplasia/cardiomyopathy: an electrocardiogram-based review.
Nunes de Alencar Neto J, Baranchuk A, Bayés-Genís A, Bayés de Luna A
Europace 2018 Jun 1;20(FI1):f3-f12. doi: 10.1093/europace/eux202. PMID: 29272363
Changes in follow-up ECG and signal-averaged ECG in patients with arrhythmogenic right ventricular cardiomyopathy.
Bae MH, Kim JH, Jang SY, Park SH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC
Pacing Clin Electrophysiol 2014 Apr;37(4):430-8. Epub 2013 Oct 25 doi: 10.1111/pace.12285. PMID: 24164254

Recent systematic reviews

Genotype-phenotype relationship in patients with arrhythmogenic right ventricular cardiomyopathy caused by desmosomal gene mutations: A systematic review and meta-analysis.
Xu Z, Zhu W, Wang C, Huang L, Zhou Q, Hu J, Cheng X, Hong K
Sci Rep 2017 Jan 25;7:41387. doi: 10.1038/srep41387. PMID: 28120905Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Reviews

    Related information

    • PMC Articles
      Related information in PubMed Central Links
    • PubMed
      Related literature resources in PubMed

    Recent activity

    Clear Turn Off Turn On

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...