Analysis of J waves during myocardial ischaemia

Abstract

J-wave augmentations were caused by myocardial ischaemia during coronary spasms. The presence and augmentation of J waves, especially prominent J waves with the characteristic ST-elevation patterns, were associated with VF.

Early repolarization and positive T-wave alternans as risk markers for life-threatening arrhythmias in patients with vasospastic angina

“…Our study also showed that p-TWA together with baseline ER was the predictive factor of ventricular tachyarrhythmia, but p-TWA alone did not predict which patients would develop multi-vessel vasospasm. There are multiple factors that are supposed to cause ER, such as cardiac ischemia [32], depolarization [26] and/or repolarization [33] abnormalities, and the effect of autonomic nerves [34]. The present results might suggest that ER had additional contributors different from inhomogeneity of ventricular repolarization that could be detected by p-TWA.…”

Acute Myocardial Infarction with a Left Main Trunk Lesion and Documented Lambda-like J Waves

“…The J-wave-like ST segment elevation pattern, similar to a grade-III ischemia pattern (14), which was observed after cardioversion, was considered to be a J wave, since no initial upsloping phase of the ST-T complex was observed (5). Furthermore, this feature of the J wave was considered to be what we call a "Lambda wave," as described by Riera et al (15), which was subsequently named by Gussak and recently reported by the Jastrzebski and Aizawa groups (9,16,17).…”

“…In addition, the excessive ST segment elevation in I, aVL, V1-V6 may also be explained by the LMT stenosis, as well as the severe delay in the LAD. Recently, an association between J waves and myocardial ischemia has also been reported (9,23,24). According to those reports, the global ischemia induced by the right coronary artery (RCA) and/or left coronary artery (LCA) tended to generate J waves mainly in the inferolateral leads and rarely in the precordial leads.…”

“…Similar observations had been already reported in several papers (6)(7)(8). More recently, the relationship between the J-wave dynamics and arrhythmias during myocardial ischemia in patients with vasospastic angina was also systemically investigated (9).…”

Life-Threatening Ventricular Arrhythmia Following Exercise-Induced Vasospastic Myocardial Ischemia at the Site of a Myocardial Bridge With Progressive J-Wave Manifestation

“…The VSA at the site of the myocardial bridge in the mid-LAD caused the non-progressive J-wave manifestation and the ST-segment elevation at the same time. 1 The VSA was considered to be the cause of the STsegment elevation during the treadmill exercise test, as well as during ICD implantation. The likely mechanism of the VSA at the site of the myocardial bridge during both exercise test and ICD implantation was hypersensitivity to catecholamine because of endothelial dysfunction by chronic mechanical stress due to systolic squeezing.…”