Abstract：
BACKGROUND: Several investigations have shown that existing risk stratification processes remain insufficient for stratifying sudden cardiac death risk in arrhythmogenic right ventricular cardiomyopathy (ARVC). Multiple auxiliary parameters are investigated to offer a more precise prognostic model. Our aim was to assess the association between several ECG markers (epsilon waves, prolonged terminal activation duration (TAD) of QRS, fragmented QRS (fQRS), late potentials on signal-averaged electrocardiogram (SA-ECG), T-wave inversion (TWI) in right precordial leads, and extension of TWI in inferior leads) with the risk of developing poor outcomes in ARVC.
METHODS: A systematic literature search from several databases was conducted until September 9th, 2023. Studies were eligible if it investigated the relationship between the ECG markers with the risk of developing ventricular arrhythmic events.
RESULTS: This meta-analysis encompassed 25 studies with a total of 3767 participants. Our study disclosed that epsilon waves, prolonged TAD of QRS, fQRS, late potentials on SA-ECG, TWI in right precordial leads, and extension of TWI in inferior leads were associated with the incremental risk of ventricular arrhythmias, implantable cardioverter-defibrillator shock, and sudden cardiac death, with the risk ratios ranging from 1.46 to 2.11. In addition, diagnostic test accuracy meta-analysis stipulated that the extension of TWI in inferior leads had the uppermost overall area under curve (AUC) value amidst other ECG markers apropos of our outcomes of interest.
CONCLUSIONS: A multivariable risk assessment strategy based on the previously stated ECG markers potentially enhances the current risk stratification models in ARVC patients, especially extension of TWI in inferior leads.
METHODS: A systematic literature search from several databases was conducted until September 9th, 2023. Studies were eligible if it investigated the relationship between the ECG markers with the risk of developing ventricular arrhythmic events.
RESULTS: This meta-analysis encompassed 25 studies with a total of 3767 participants. Our study disclosed that epsilon waves, prolonged TAD of QRS, fQRS, late potentials on SA-ECG, TWI in right precordial leads, and extension of TWI in inferior leads were associated with the incremental risk of ventricular arrhythmias, implantable cardioverter-defibrillator shock, and sudden cardiac death, with the risk ratios ranging from 1.46 to 2.11. In addition, diagnostic test accuracy meta-analysis stipulated that the extension of TWI in inferior leads had the uppermost overall area under curve (AUC) value amidst other ECG markers apropos of our outcomes of interest.
CONCLUSIONS: A multivariable risk assessment strategy based on the previously stated ECG markers potentially enhances the current risk stratification models in ARVC patients, especially extension of TWI in inferior leads.
摘要：
背景：一些研究表明，现有的风险分层过程仍然不足以对心律失常性右心室心肌病（ARVC）的猝死风险进行分层。研究了多个辅助参数，以提供更精确的预后模型。我们的目的是评估几种心电图标志物(ε波，QRS的终末激活持续时间（TAD）延长，分段QRS(fQRS)，信号平均心电图（SA-ECG）上的晚期电位，右心前导联T波倒置(TWI),和TWI在劣等导线中的延伸），有在ARVC中发展不良结局的风险。
方法：从几个数据库进行了系统的文献检索，直到9月9日，2023年。如果研究了ECG标记物与发生室性心律失常事件的风险之间的关系，则研究合格。
结果：这项荟萃分析包括25项研究，共有3767名参与者。我们的研究表明，ε波，QRS的TAD延长，fQRS,SA-ECG的晚期电位，右心前导联的TWI，下导联中TWI的延伸与室性心律失常的风险增加有关，植入式心脏复律除颤器休克,和心源性猝死,风险比在1.46至2.11之间。此外,诊断试验准确性荟萃分析规定,TWI在下导联中的延伸具有最高的整体曲线下面积(AUC)值,这与我们感兴趣的结局相关的其他ECG标志物相比.
结论：基于先前陈述的ECG标记的多变量风险评估策略可能会增强ARVC患者当前的风险分层模型，尤其是TWI在劣质导线中的延伸。
方法：从几个数据库进行了系统的文献检索，直到9月9日，2023年。如果研究了ECG标记物与发生室性心律失常事件的风险之间的关系，则研究合格。
结果：这项荟萃分析包括25项研究，共有3767名参与者。我们的研究表明，ε波，QRS的TAD延长，fQRS,SA-ECG的晚期电位，右心前导联的TWI，下导联中TWI的延伸与室性心律失常的风险增加有关，植入式心脏复律除颤器休克,和心源性猝死,风险比在1.46至2.11之间。此外,诊断试验准确性荟萃分析规定,TWI在下导联中的延伸具有最高的整体曲线下面积(AUC)值,这与我们感兴趣的结局相关的其他ECG标志物相比.
结论：基于先前陈述的ECG标记的多变量风险评估策略可能会增强ARVC患者当前的风险分层模型，尤其是TWI在劣质导线中的延伸。
