Fontaine Leads

Epsilon Wave Definition Small deflection (“blip” or “wiggle”) buried in the end of the QRS complex On Standard 12-lead ECG (S-ECG), best seen in ST segment of V1 and V2, they are usually present in leads V1 through V4 Caused by post-excitation of myocytes in the right ventricle Characteristic finding in patients with arrhythmogenic right ventricular dysplasia (ARVD) Epsilon wave in V1 due to RV conduction delay Epsilon waves are the most specific and characteristic finding in arrhythmogenic right ventricular dysplasia (ARVD). In ARVD, myocytes are replaced by fat, producing islands of viable myocytes in a sea of fat. This causes a delay in excitation of some of the myocytes of the right ventricle, producing a small “blip” seen during the ST segment of the ECG. ...

The ECG is one of the most useful investigations in medicine. Electrodes attached to the chest and/or limbs record small voltage changes as potential difference, which is transposed into a visual tracing Basic landmarks 3-electrode system Uses 3 electrodes (RA, LA and LL) Monitor displays the bipolar leads (I, II and III) To get best results – Place electrodes on the chest wall equidistant from the heart (rather than the specific limbs) ...