The presence of giant epsilon waves in a patient with arrhythmogenic right ventricular cardiomyopathy.

Epsilon wave, which is a major diagnosis criterion for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVD/C), is defined as small amplitude potentials. The present case is a 49-year-old man with a history of syncope and palpitations for 6 months. The ECG documented ventricular tachycardia (VT) when the patient has palpitations. However, there has been a giant epsilon wave in sinus rhythm. Electroanatomic mapping also has a prominent double potential identified on ABL catheter. The amplitude of epsilon wave reached 0.9 mV, which might be the maximum epsilon wave until now.