J-Wave in Patients With Syncope

Abstract

2216CHIBA Y et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jpIn this study we evaluated the clinical significance of syncope and J-wave. Although it has been reported that syncope is a sign of sudden cardiac death (SCD) in patients with J-wave, 9 the management of syncope in patients with J-wave remains controversial.To our knowledge, there are few studies on the prevalence of J-wave in patients with syncope. To evaluate the possibility that syncope in patients with/without J-wave is caused by NMRS, we investigated whether head-up tilt test (HUT), a useful tool for diagnosing NMRS, can provide further insights into the relationship between syncope and J-wave.We therefore determined the prevalence of J-wave in patients with syncope in order to clarify the association between NMRS and J-wave. Methods SubjectsThree hundred and twenty-six consecutive patients with syncope who presented to the Department of Cardiology, Showa he presence of J-wave, also known as early repolarization (ER), is a common finding on electrocardiogram (ECG) that is seen in 1-10% of the general population, 1,2 especially in young people. J-wave is characterized by a positive deflection at the terminal of the QRS complex or notching/slurring at the terminal of the QRS complex on ECG. Its potential arrhythmogenicity, more recently, has been reported in clinical and experimental studies. 3-5 Fatal arrhythmia, however, is not commonly seen in patients with J-wave. 6 Editorial p 2110Syncope is also a common occurrence in 1-5% of the general population. 7,8 Neurally mediated reflex syncope (NMRS) is a most frequent cause of syncope. Cardiovascular event and life-threatening arrhythmia are also causes of syncope or cardiac arrest. These are important risk factors for mortality, but clinical diagnosis in some patients with syncope is difficult in the primary care setting. Fatal arrhythmia is not commonly seen in patients with syncope. Background: Syncope is a common occurrence. The presence of J-wave, also known as early repolarization, on electrocardiogram is often seen in the general population, but the relationship between syncope and J-wave is unclear.

J Wave Is Better Left Alone?

“…Chiba et al report that 37% of patients with syncope had a J wave. 4 This is high compared with the 3.5% in the general Japanese population. 7 Although the prevalence is comparable to that reported in a previous study from Poland (31%), 8 in the Framingham Heart Study it was only 6.1% and another recent report showed about half that among syncope subjects.…”

Incidence of “J Wave Syndromes” and Their Risk Stratification in Resident Doctors and Young Faculty Staff of a Tertiary Care Teaching Hospital

“…Definite evidence exists which explains the positive relationship between early repolarization, emotional stress, and sudden cardiac death. [25] This was the major reason for selecting health care workers as a target population in the present study. However, multicentric studies with a larger sample size are needed to reinforce the relationship between stress and J wave syndrome.…”