Anterior T-Wave Inversion Occurrence in Asymptomatic Young Adults

HealthDay News – Anterior T-wave inversion (ATWI) occurs in 2.3% of young asymptomatic adults, usually in leads V1 and V2, according to a study published in the Journal of the American College of Cardiology.

Aneil Malhotra, MBBChir, from St. George’s University of London, and colleagues examined the prevalence and significance of ATWI in a cohort of 14,646 white individuals aged 16 to 35 years. Participants were evaluated using a health questionnaire, physical examination, and 12-lead electrocardiography.

The researchers detected ATWI in 2.3% of individuals, and it was more common in women than men (4.3% vs 1.4%) and in athletes vs nonathletes (3.5% vs 2.0%; both P <.0001). T-wave inversion was mainly seen in leads V1 and V2 (77%); ATWI beyond V2 was seen in 1.2% of women and 0.2% of men. After further evaluation, no one with ATWI fulfilled the diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy. None of the individuals with ATWI experienced an adverse event during a mean follow-up of 23.1 ± 12.2 months.

“ATWI confined to leads V1 to V2 is a normal variant or physiological phenomenon in asymptomatic white individuals without a relevant family history,” the authors wrote. “ATWI beyond V2 is rare, particularly in men, and may warrant investigation.”

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  1. Malhotra A, Dhutia H, Gati S, et al. Anterior T-wave inversion in young white athletes and nonathletes. Prevalence and significance. J Am Coll Cardiol. 2017;69(1):1-9. doi:10.1016/j.jacc.2016.10.044.
  2. Kirchhof P, Fabritz L. Anterior T-wave inversion does not convey short-term sudden death risk. Inverted is the new normal. J Am Coll Cardiol. 2017;69(1):doi:10.1016/j.jacc.2016.11.011.