7th March 2024

Investigations

ARVC is commonly diagnosed through imaging modalities requested as a result of suspicious ECG findings or symptoms.

Typical ECG features will include T wave inversion in V1-V3, QRS widening in V1-V3 and frequent ventricular ectopics. The most specific finding is that of an epsilon wave – a small deflection at the end of the QRS complex which represents post-excitation of the RV myocytes.

Echocardiography will typically demonstrate RV outflow tract dilation and reduction in RV fractional area change (a similar measure to ejection fraction in the LV but measured in one plane rather than two)

Cardiac MRI is very useful in demonstrating the underlying pathology, with RV enlargement and thinning, fatty infiltration and fibrosis of the wall.

If there is a suspicion of familial inheritance then genetic testing can be performed to identify the genetic abnormality and genetic counselling should be offered to first degree family members.