Background-Early repolarization pattern is a common ECG finding characterized by J-point elevation and QRS notching or slurring in the inferior and/or lateral leads, yet little is known about its incidence and long-term prognosis in Asian populations. Methods and Results-We reviewed all the ECG records of the 5976 atomic-bomb survivors who were examined at least once during our biennial health examination in Nagasaki, Japan, between

rugada syndrome (BS) is characterized by a covedtype or type 1 ST-segment elevation in the right precordial leads (V1-3) of the 12-lead electrocardiogram (ECG), as well as symptoms such as documented ventricular fibrillation (VF), polymorphic ventricular tachycardia (VT), family history of sudden death, coved-type ECGs in family members, inducibility of polymorphic VT or VF with programmed electrical stimulation, syncope, or nocturnal agonal respiration. 1,2 Several mutations in SCN5A, the α subunit of the sodium channel, have been linked to BS, 3-5 which displays an autosomal dominant mode of transmission with low penetrance. Although BS is inherited with equal frequency by men and women, most of the reported cases have been in adult men. 6,7 In 2 reported cases of Brugada-like ECG, the typical pattern of coved-type ST elevation disappeared following surgical castration for prostate cancer. 8 Men with BS have significantly higher plasma testosterone levels than age-matched male controls, 9 which suggests that testosterone may contribute to the BS phenotype. Editorial p 35There is evidence to suggest that testosterone also plays a pathophysiological role in the etiology of prostate cancer. Testosterone is essential for normal growth and maintenance of the prostate, but it also stimulates the proliferation of human prostate cancer cells in vitro and produces prostate cancer in rodents. 10,11 Thus, we examined the relationship between the Brugada-like ECG with either the covedtype or saddle-back-type ST elevation and prostate cancer. Methods General ProceduresA total of 7,564 atomic bomb survivors (3,374 men; 4,190 women) have been followed biennially in Nagasaki, Japan since July 1, 1958 as part of a follow-up program conducted by the Radiation Effects Research Foundation (RERF). Detailed descriptions of the program have been published elsewhere. 12,13 Each examination includes a physical check-up, 12-lead ECG, and blood pressure measurement by sphygmomanometer while the subjects are seated after resting for at least 5 min. First and fifth Korotkoff phases, respectively, are used for the systolic and diastolic blood pressure (SBP and DBP) readings. Standing height (m) and body weight (kg) are measured without socks or outer clothing and the body mass index (BMI: kg/m 2 ) is calculated. Blood is sampled from a cubital vein for determination of serum cholesterol (mg/dl) and hemoglobin (g/dl). At each examination up to 12 clinical diagnoses are made and stored in a database using the International Classification of Disease (ICD) 7 th , 8 th , 9 th and 10 th editions.

Background: Thyrotoxicosis is known to be associated with sinus tachycardia and supraventricular tachyarrhythmias, but rarely with ventricular fibrillation (Vf), which has only occurred in some patients with hypokalemic periodic paralysis or ischemic heart disease. Patient Findings: We present three men who were transferred to our hospital with Graves' disease who developed idiopathic Vf. None of them had hypokalemic periodic paralysis or ischemic heart disease but all were smokers. None of other patients with thyrotoxicosis (587 females and 155 males) who were seen at our hospital, in the period during which the three men were seen, had idiopathic Vf. In our three men with thyrotoxicosis and idiopathic Vf, there was no identifiable underlying heart disease. One of the three patients died of hypoxic encephalopathy. The other two men did not have recurrent Vf after their thyroid function normalized. Summary: These cases and a review of similar cases in the literature imply that improving thyrotoxicosis seems to be effective for treating idiopathic Vf in some patients. Conclusions: Our findings suggest that thyroid hormone excess might play a direct role in the development of Vf in susceptible individuals. Our experience with these three patients suggests that smoking men with thyrotoxicosis likely have an increased risk for Vf, even if they do not have other predisposing factors.