In their report regarding the rationale of naming this right ventricular disease entity with a high arrhythmogenic susceptibility related to sudden death, Fontaine and Chen claim that arrhythmogenic right ventricular dysplasia is back in force. These investigators appropriately developed several arguments in favor of the “maldevelopment” theory of arrhythmogenic right ventricular dysplasia.
Fontaine explained how he discovered the epsilon wave, which is the electrocardiographic manifestation of structural anomalies in right ventricle. However, the definition of epsilon wave given by the investigators seems to my knowledge inaccurate. Indeed, they characterized this pattern as “a slur at the end of right precordial QRS complex.”
By definition, a slur atypical repolarization, which is one of the both variants of early repolarization ( Figure 1 ), is a smooth transition from QRS to ST segment, in contrast to the notch pattern, which is positive J deflection inscribed on the last portion of the R/S wave. Moreover, the low amplitude of R wave in V 1 and often in V 2 is prompt to inscribe a notch rather than a slur pattern of repolarization. Therefore, I would say that epsilon wave is a notch pattern rather than a slur one.
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