Which finding on surface ECG is considered highly specific for arrhythmogenic right ventricular cardiomyopathy?
- A Delta wave in lead II
- B Epsilon wave in right precordial leads V1 to V3 ✓
- C Osborn waves in inferior leads
- D S1Q3T3 pattern
Correct answer: B. Epsilon wave in right precordial leads V1 to V3
Explanation
The epsilon wave is a small deflection just after the QRS in V1 to V3, representing delayed depolarization of residual myocytes embedded in fibrofatty RV tissue, and it is a major Task Force criterion for ARVC. Delta wave indicates Wolff-Parkinson-White pre-excitation, Osborn waves indicate hypothermia or hypocalcemia, and S1Q3T3 suggests pulmonary embolism.
Reference: Braunwald's Heart Disease, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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