Electrocardiographic early repolarization characteristics and clinical presentations in the young: a benign finding or worrisome marker for arrhythmias
dc.contributor.author | Safa, Raya | |
dc.contributor.author | Thomas, Ronald | |
dc.contributor.author | Karpawich, Peter P. | |
dc.date.accessioned | 2017-04-13T20:35:54Z | |
dc.date.available | 2018-04-02T18:03:24Z | en |
dc.date.issued | 2017-01 | |
dc.identifier.citation | Safa, Raya; Thomas, Ronald; Karpawich, Peter P. (2017). "Electrocardiographic early repolarization characteristics and clinical presentations in the young: a benign finding or worrisome marker for arrhythmias." Congenital Heart Disease 12(1): 99-104. | |
dc.identifier.issn | 1747-079X | |
dc.identifier.issn | 1747-0803 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/136329 | |
dc.description.abstract | BackgroundThe early ECG repolarization QRS pattern (ERp), with J‐point elevation of 0.1 mV in two contiguous inferior and/or lateral leads, can be associated with ventricular arrhythmias among adults. The significance of an ERp in the young is unknown.ObjectiveThe purpose of this study was to assess the prevalence of ERp among young patients (pts), describe and correlate the characteristics with clinical presentations and any arrhythmias.MethodsThis was a 1 y retrospective review of ECGs obtained from patients referred specifically for documented arrhythmias, possible arrhythmia‐related symptoms or sports clearance. ECGs were analyzed for ERp (J‐point, ascending/horizontal patterns, location) and correlated with presenting complaints.ResultsOf 301 patient ECGs, an ERp was found in 177 (59%), (pts age 11.7 ± 4.3 y); 54% male; 23% Caucasian. Of these, 6 pts had a family history of sudden cardiac death. Arrhythmias (72% atrial) occurred in 22 pts. Only 3 pts had ventricular arrhythmias (1 successfully ablated). The ascending ST segment and elevated J‐point occurred in 77% and 51% of pts with and without arrhythmias respectively. In 73% of all pts, the ERp location was in inferior/lateral leads. Neither gender, ethnicity, large J‐point, lead location, nor the combination of a horizontal ST segment with large J‐point correlated with any arrhythmias.ConclusionsERp, especially the diffuse ascending pattern, is common among the young, in those of European ethnicity, found equally in both genders, and with no apparent correlation with atrial nor ventricular arrhythmias. | |
dc.publisher | Wiley Periodicals, Inc. | |
dc.subject.other | tachycardia | |
dc.subject.other | sudden death | |
dc.subject.other | early repolarization | |
dc.subject.other | arrhythmias | |
dc.title | Electrocardiographic early repolarization characteristics and clinical presentations in the young: a benign finding or worrisome marker for arrhythmias | |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.description.peerreviewed | Peer Reviewed | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/136329/1/chd12410.pdf | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/136329/2/chd12410_am.pdf | |
dc.identifier.doi | 10.1111/chd.12410 | |
dc.identifier.source | Congenital Heart Disease | |
dc.identifier.citedreference | Surawicz B, Macfarlane PW. Inappropriate and confusing electrocardiographic terms: J‐wave syndromes and early repolarization. J Am Coll Cardiol. 2011; 57 ( 15 ): 1584 – 1586. | |
dc.identifier.citedreference | Mizusawa Y, Bezzina CR. Early repolarization pattern: its ECG characteristics, arrhythmogeneity and heritability. J Interv Card Electrophysiol. 2014; 39 ( 3 ): 185 – 192. | |
dc.identifier.citedreference | Rosso R, Glikson E, Belhassen B, et al. Distinguishing “benign” from “malignant early repolarization”: the value of the ST‐segment morphology. Heart Rhythm. 2012; 9 ( 2 ): 225 – 229. | |
dc.identifier.citedreference | Nunn LM, Bhar‐Amato J, Lowe MD, et al. Prevalence of J‐point elevation in sudden arrhythmic death syndrome families. J Am Coll Cardiol. 2011; 58 ( 3 ): 286 – 290. | |
dc.identifier.citedreference | Noseworthy PA, Tikkanen JT, Porthan K, et al. The early repolarization pattern in the general population: clinical correlates and heritability. J Am Coll Cardiol. 2011; 57 ( 22 ): 2284 – 2289. | |
dc.identifier.citedreference | Wibke R, Kaess BM, Debiec R, et al. Heritability of early repolarization: a population‐based study. Circ Cardiovasc Genet. 2011; 30 ( 4 ): 134 – 138. | |
dc.identifier.citedreference | Adlera A, Gollob MH. A practical guide to early repolarization. Curr Opin Cardiol. 2015; 30: 8 – 16. | |
dc.identifier.citedreference | Aizawa Y, Sato A, Watanabe H, Chinushi M. Dynamicity of the J‐wave in idiopathic ventricular fibrillation with a special reference to pause‐dependent augmentation of the J‐wave. J Am Coll Cardiol. 2012; 59 ( 22 ): 1948 – 1953. | |
dc.identifier.citedreference | Antzelevitch C, Yang GX. J wave syndromes. Heart Rhythm. 2010; 7 ( 4 ): 549 – 558. | |
dc.identifier.citedreference | Haïssaguerre M, Derval N, Sacher F, et al. Sudden cardiac arrest associated with early repolarization. N Engl J Med. 2008; 358: 2016 – 2023. | |
dc.identifier.citedreference | Tikkanen JT, Anttonen O, Junttila MJ, et al. Long‐term outcome associated with early repolarization on electrocardiography. N Engl J Med. 2009; 361 ( 26 ): 2529 – 2537. | |
dc.identifier.citedreference | Yan GX, Antzelevitch C. Cellular basis for the electrocardiographic J wave. Circulation. 1996; 93: 372 – 379. | |
dc.identifier.citedreference | Gussak I, Antzelevitch C. Early repolarization syndrome: Clinical characteristics and possible cellular and ionic mechanisms. J Electrocardiol. 2000; 33: 299 – 309. | |
dc.identifier.citedreference | Antzelevitch C, Yan GX, Viskin S. Rationale for the use of the terms J‐wave syndromes and early repolarization. J Am Coll Cardiol. 2011; 57 ( 15 ): 1587 – 1590. | |
dc.identifier.citedreference | Derval N, Simpson CS, Birnie DH, et al. Prevalence and characteristics of early repolarization in the CASPER registry: cardiac arrest survivors with preserved ejection fraction registry. J Am Coll Cardiol. 2011; 58 ( 7 ): 722 – 728. | |
dc.identifier.citedreference | Sinner MF, Reinhard W, Muller M, et al. Association of early repolarization pattern on ECG with risk of cardiac and all‐cause mortality: a population‐based prospective cohort study. PLoS Med. 2010 Jul 27; 7 ( 7 ): e1000314. | |
dc.identifier.citedreference | Pargaonkar VS, Perez MV, Jindal A, Mathur MB, Myers J, Froelicher VF. Long‐term prognosis of early repolarization with J‐wave and QRS slur patterns on the resting electrocardiogram: a cohort study. Ann Intern Med. 2015; 163 ( 10 ): 747 – 755. | |
dc.identifier.citedreference | Rollin A, Maury P, Bongard V, et al. Prevalence, prognosis, and identification of the malignant form of early repolarization pattern in a population‐based study. Am J Cardiol. 2012; 110 ( 9 ): 1302 – 1308. | |
dc.identifier.citedreference | Junttila MJ, Sager SJ, Freiser M, McGonagle S, Castellanos A, Myerburg RJ. Inferolateral early repolarization in athletes. J Interv Card Electrophysiol. 2011; 31 ( 1 ): 33 – 38. | |
dc.identifier.citedreference | Perez MV, Uberoi A, Jain NA, Ashley E, Turakhia MP, Froelicher V. The prognostic value of early repolarization with ST‐segment elevation in African Americans. Heart Rhythm. 2012; 9 ( 4 ): 558 – 565. | |
dc.identifier.citedreference | Wasserburger RH, Alt WJ. The normal RS‐T segment elevation variant. Am J Cardiol. 1961; 8: 184 – 192. | |
dc.identifier.citedreference | Klatsky AL, Oehm R, Cooper RA, Udaltsova N, Armstrong MA. The early repolarization normal variant electrocardiogram: correlates and consequences. Am J Med. 2003;15; 115 ( 3 ): 171 – 177. | |
dc.identifier.citedreference | Rautaharju PM, Surawicz B, Gettes LS. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology. Circulation. 2009; 119: e241 – e250. | |
dc.identifier.citedreference | KK, Patton Patrick T, M, Ezekowitz, et al. Scientific statement from the American Heart Association. Circulation. 2016; 133: 1520 – 1529. | |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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