This diagnostic image is a 12-lead electrocardiogram (ECG) demonstrating key diagnostic features of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC). The tracing shows a normal sinus rhythm with low voltage in the frontal plane leads (I, II, III, aVR, aVL, aVF). A pathognomonic 'epsilon wave' is identified by a blue arrow in lead V1, appearing as a small, low-amplitude notch or positive deflection at the end of the QRS complex and the beginning of the ST segment. Significant repolarization abnormalities are present, specifically deep T-wave inversions across the right precordial leads (V1, V2, and V3). These findings, particularly the combination of terminal notch depolarization (epsilon wave) and precordial T-wave inversion, serve as major diagnostic criteria for ARVC. The educational focus of the image is to illustrate ECG manifestations of right ventricular disease and structural heart conditions associated with sudden cardiac arrest.

This diagnostic image contains three panels of electrocardiogram (ECG) tracings illustrating the electrical manifestations of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC). Panel A provides a high-magnification view of lead V1, where red arrows indicate the hallmark Epsilon wave—a low-amplitude notch or 'blip' occurring at the end of the QRS complex and the start of the ST segment. Panel B displays precordial leads V1 through V3, demonstrating a right bundle branch block (RBBB) morphology characterized by widened QRS complexes and persistent T-wave inversions. Panel C presents a standard 12-lead ECG overview following hemodynamic stabilization. The collection emphasizes key diagnostic criteria including repolarization abnormalities (T-wave inversion in V1-V3) and depolarization abnormalities (Epsilon waves). These visual findings are critical for medical students and clinicians in identifying structural right ventricular disease and assessing sudden cardiac death risk.

A 12-lead electrocardiogram (ECG) demonstrating key diagnostic features of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC). The tracing shows a sinus rhythm with a widened QRS complex and a morphology consistent with a Right Bundle Branch Block (RBBB). Blue arrows indicate the presence of Epsilon waves, characterized by low-amplitude positive deflections at the terminal end of the QRS complex, specifically visible in leads aVR and V1. Red arrows highlight deep, symmetrical T-wave inversions (TWI) across the precordial leads V1 through V4. These findings represent classic depolarization and repolarization abnormalities associated with ARVC. The image serves as a high-yield educational resource for cardiology and emergency medicine, illustrating the specific ECG criteria used for the diagnosis of right ventricular structural heart disease and the assessment of sudden cardiac death (SCD) risk factors in young adults.

This diagnostic image displays a focused 12-lead electrocardiogram (ECG) tracing specifically highlighting the precordial leads V1 through V6. The visual focuses on the right precordial leads (V1, V2, and V3), which are marked with red circles and arrows to indicate diagnostic abnormalities. Key morphological features include prominent T-wave inversions in leads V1-V3, while the lateral leads V4-V6 show upright T-waves. A critical finding is the presence of an 'epsilon wave,' identified as a small positive deflection or notch at the terminal end of the QRS complex, occurring between the end of the S-wave and the start of the T-wave. These electrocardiographic signs—T-wave inversion in right precordial leads beyond V1 and the presence of epsilon waves—are highly characteristic of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC). This image serves as a clinical teaching tool for identifying subtle depolarization and repolarization abnormalities associated with fibrofatty replacement of the right ventricular myocardium.