Epsilon wave detected by an Apple Watch Series 5 in a patient with biventricular arrhythmogenic cardiomyopathy

Abstract

A 32-year-old man with a family history of sudden cardiac death due to arrhythmogenic cardiomyopathy (ACM) was admitted following a recovered ventricular fibrillation cardiac arrest . A family genetic study had detected that the patient carried a mutation on the desmoplaquin gene. Transthoracic echocardiography revealed a moderately dilated right ventricle with distal hypertrabeculation and decreased systolic function. The left ventricle was also dilated and showed impaired global systolic function. A conventional 12-lead electrocardiogram (ECG) was performed showing sinus rhythm, a slight deflection at the end of the QRS in V1–V2, and T-wave inversion in lateral leads (Figure 1). In addition to standard ECG, quasistandard precordial leads were obtained with an Apple Watch Series 5, displaying intraventricular