• Electrical alterations are typically seen before structural changes.
  • The classical clinical presentation is the occurrence of ventricular arrhythmias.
    • Typically LBBB morphology and superior axis
  • The figure shows precordial ECG leads from an AC patient at rest with typical T wave inversions in V1 – V4 (red arrows).
  • An AC diagnosis based on imaging criteria with completely normal ECG is rare.