Early Repolarization on Scalar Electrocardiogram

Mehta, M. N.; Jain, Abnash C.

doi:10.1097/00000441-199506000-00001

Cited by 114 publications

(82 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the BER pattern, the J point itself frequently is notched or irregular. This finding, although not diagnostic of BER, is highly suggestive of the diagnosis [11,13,15].…”

Section: Benign Early Repolarizationmentioning

confidence: 74%

“…The long-term health of these patients who had BER was equivalent to the control population [10]. In another large study of BER, the mean age of patients was 39 years (range, 16-80 years); although the pattern was seen across this rather broad age range, it was encountered predominantly in patients less than age 50 years and rarely seen in individuals older than age 70 years [11]. The BER pattern is seen much more often in men than in women.…”

Section: Benign Early Repolarizationmentioning

confidence: 87%

“…The T waves are concordant with the QRS complex (ie, oriented in the same direction as the major portion of the QRS complex) and usually are found in the precordial leads. The height of the T waves in BER ranges from approximately 6 mm in the precordial leads to 4-6 mm in the limb leads [11,13,16]. These abnormalities are greatest in the precordial leads, particularly the precordial leads (leads V2-V5).…”

Section: Benign Early Repolarizationmentioning

confidence: 99%

See 2 more Smart Citations

ST Segment and T Wave Abnormalities Not Caused by Acute Coronary Syndromes

Brady

2006

Emergency Medicine Clinics of North America

View full text Add to dashboard Cite

The evaluation of the chest pain patient suspected of acute coronary syndrome (ACS) represents the major indication for electrocardiograph (ECG) performance in the emergency department (ED) and prehospital settings [1]. The ECG demonstrates significant abnormality in a minority of these patients, ranging from minimal nonspecific ST segment/T wave changes to pronounced STE and T wave abnormalities, including the prominent T wave, the inverted T wave, and the nonspecific T wave (Figs. 1 and 2). The ECG syndromes responsible for these various abnormalities include potentially malignant entities, such as ACS and cardiomyopathy, and less concerning patterns, such as benign early repolarization (BER) or ventricular paced rhythms (VPR) [2][3][4].In a study considering all chest pain patients with electrocardiographic ST segment depression (STD), the following clinical syndromes were responsible for the ECG abnormality: ACS, 26%; left ventricular hypertrophy (LVH), 43%; bundle branch block (BBB), 21%; VPR, 5%; left ventricular aneurysm, 3%; and other patterns, 1% [5]. Similarly, STE is a fairly common finding on the ECG of the chest pain patient and frequently does not indicate STE acute myocardial infarction (AMI). One prehospital study of adult chest pain patients revealed that, of patients manifesting STE who met criteria for fibrinolysis, most were not diagnosed with AMI; rather, LVH and left BBB were found more frequently [6]. Furthermore, in two reviews of adult ED chest pain patients with STE on ECG, the ST segment abnormality resulted from AMI in only 15%-31% of these populations; LVH, seen in 28%-30% of these patients, was a frequent cause of this STE. Other findings responsible for this STE included BER, acute

show abstract

“…In the BER pattern, the J point itself frequently is notched or irregular. This finding, although not diagnostic of BER, is highly suggestive of the diagnosis [11,13,15].…”

Section: Benign Early Repolarizationmentioning

confidence: 74%

Section: Benign Early Repolarizationmentioning

confidence: 87%

Section: Benign Early Repolarizationmentioning

confidence: 99%

See 1 more Smart Citation

ST Segment and T Wave Abnormalities Not Caused by Acute Coronary Syndromes

Brady

2006

Emergency Medicine Clinics of North America

View full text Add to dashboard Cite

show abstract

“…The early repolarization pattern, consisting of a distinct J wave or J point elevation, a notch or slur of the terminal part of the QRS and an ST segment elevation, is predominantly found in healthy young males and has traditionally been viewed as benign 2,3 . Our observation in 2000 that an ER pattern in the canine coronary-perfused wedge preparation can easily convert to one in which phase 2 reentry gives rise to polymorphic ventricular tachycardia/ ventricular fibrillation (VT/VF), prompted the suggestion that ER may in some cases predispose to malignant arrhythmias in the clinic 1,4,5 .…”

mentioning

confidence: 99%

J Wave Syndromes: From Cell to Bedside

Antzelevitch¹

2011

J Arrhythmia

View full text Add to dashboard Cite

The J wave, a deflection that follows the QRS complex of the surface ECG, is usually partially buried in the R wave in humans, appearing as a J point elevation. An early repolarization (ER) pattern characterized by J point elevation, slurring of the terminal part of the QRS and ST segment elevation has long been recognized and considered to be totally benign. Recent studies have presented evidence demonstrating that an ER pattern in inferior leads or infero-lateral leads is associated with increased risk for life-threatening arrhythmias, named early repolarization syndrome (ERS). ERS and Brugada syndrome (BrS) share similar ECG characteristics, clinical outcomes, risk factors as well as a common arrhythmic platform related to amplification of I tomediated J waves. Although BrS and early repolarization syndrome (ERS) differ with respect to the magnitude and lead location of abnormal J wave manifestation, they can be considered to represent a continuous spectrum of phenotypic expression, termed J wave syndromes. ERS has been proposed to be divided into three subtypes: Type 1, displaying an ER pattern predominantly in the lateral precordial leads, is prevalent among healthy male athletes and rarely seen in VF survivors; Type 2, displaying an ER pattern predominantly in the inferior or infero-lateral leads, is associated with a higher level of risk; whereas Type 3, displaying an ER pattern globally in the inferior, lateral and right precordial leads, is associated with the highest level of risk for development of malignant arrhythmias and is often associated with VF storms. KeywordsCardiac arrhythmias; Sudden cardiac death; Sudden cardiac arrest; Transient outward current; J point elevation; Early repolarization syndrome; Brugada syndrome; Idiopathic Ventricular fibrillation; Hypothermia; STEMI The J wave is a deflection that follows the QRS complex on the surface electrocardiogram (ECG). When partially buried in the R wave, the J wave appears as a J point elevation and may be accompanied by an ST segment elevation, an ECG feature referred to as an early repolarization (ER) pattern. Recent studies have provided evidence in support of an © 2011 Elsevier Inc. All rights reserved. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflicts of Interest:There are no conflicts of interest to disclose. The early repolarization pattern, consisting of a distinct J wave or J point elevation, a notch or slur of the terminal part of the QRS and an ST segment elevation, is predominantly found in healthy young males and has traditionally been viewed as benign 2, 3 . Our observation i...

show abstract

“…In this regard, it is also noteworthy that there is a significant discrepancy among studies when it comes to the definition of ERP [Patton 2016]: In the sense of earlier and some recent more permissive definitions, the pattern is so frequent in the general population that it is considered to be a benign normal variant of the ECG [Shipley 1936, Wasserburger 1961, Kambara 1976, Mehta 1995, Klatsky 2003, Maury 2013, and most individuals expressing an ERP are still at low risk for sudden arrhythmic death and remain lifelong asymptomatic. This leads us to the main challenge of the syndrome still to resolve: which ER-patients are vulnerable to sudden arrhythmic death and how to deal with those who are not.…”

Section: I11 Overviewmentioning

confidence: 99%

Cellular mechanisms underlying the effects of cilostazol, milrinone, isoproterenol and ajmaline on electrographic and arrhythmic manifestations of early repolarization syndrome, and comparative analysis of the cardiac electrophysiological effects of the optical isomers of mexiletine

Patocskai¹

View full text Add to dashboard Cite

Early Repolarization on Scalar Electrocardiogram

Cited by 114 publications

References 46 publications

ST Segment and T Wave Abnormalities Not Caused by Acute Coronary Syndromes

ST Segment and T Wave Abnormalities Not Caused by Acute Coronary Syndromes

J Wave Syndromes: From Cell to Bedside

Cellular mechanisms underlying the effects of cilostazol, milrinone, isoproterenol and ajmaline on electrographic and arrhythmic manifestations of early repolarization syndrome, and comparative analysis of the cardiac electrophysiological effects of the optical isomers of mexiletine

Contact Info

Product

Resources

About