Epsilon Wave

Wed, 16 Jul 2025 00:00:00 +0000

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.

ECG Lead positioning

Sun, 30 Jan 2022 00:00:00 +0000

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)

Fontaine Leads on ECG Library – LITFL Basics

Epsilon Wave

Epsilon Wave Definition

ECG Lead positioning

Basic landmarks

3-electrode system