PRECORDIAL LEADS RIGHT AND SUDDEN-DEATH - RELATION WITH ARRHYTHMOGENIC RIGHT-VENTRICULAR DYSPLASIA

Non-coronary ST-segment elevation during right sided chest pain has be en described in subjects with episodes of ventricular fibrillation at rest. This syndrome has been attributed to functional phenomena or to structural myocardial changes. A personal case has features belonging to two categories : ST-segment elevation observed before, during and a fter episodes of arrhythmia was compared to 11 previously recorded ECG recordings. Right ventricular dysplasia was shown by electrocardiogra phy, electrophysiology and echocardiography. In addition, ST-segment e levation is classified in 3 categories : triangular and dome-shaped ar e the most commonly observed forms during the arrhythmias; the third f orm with ''saddle''-shaped appearances has not been previously describ ed and would seem to be a minor equivalent observed during intercritic al periods. This form is found in 30 % of clinically documented cases of arrhythmogenic right ventricular dysplasia.