Which electrocardiographic finding is characteristically described in arrhythmogenic right ventricular cardiomyopathy?
- A Osborn waves in inferior leads
- B Delta wave with short PR interval
- C Epsilon wave in right precordial leads ✓
- D Low voltage limb leads with electrical alternans
Correct answer: C. Epsilon wave in right precordial leads
Explanation
The epsilon wave is a small deflection just after the QRS complex in leads V1 to V3, representing delayed depolarization of surviving myocytes embedded in fibrofatty right ventricular tissue. It is one of the major Task Force criteria for ARVC. C delta wave with short PR indicates Wolff-Parkinson-White preexcitation, Osborn waves are seen in hypothermia and some bradyarrhythmias, and low voltage with alternans suggests large pericardial effusion.
Reference: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 12th ed.
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