J-waves in patients with an acute ST-elevation myocardial infarction who underwent successful percutaneous coronary intervention: prevalence, pathogenesis, and clinical implication

Abstract

Many patients in the early recovery phase after an acute MI had J-waves. This ECG phenomenon was associated with an increased incidence of ventricular arrhythmias. The tachycardia-dependent augmentation of the J-wave amplitude suggested a mechanistic role of conduction delay.

Electrocardiographic parameters effectively predict ventricular tachycardia/fibrillation in acute phase and abnormal cardiac function in chronic phase of ST‐segment elevation myocardial infarction

“…In the early stage of myocardial infarction, increased cardiac repolarization dispersion and electric heterogeneity underlay VT/VF formation . Electrocardiographic (ECG) parameters, such as new‐onset atrial fibrillation (AF), J wave, J‐point elevation, and QT interval prolongation, are considered indicators of abnormal cardiac repolarization, and somewhat valuable for predicting VT/VF . However, in other studies and our clinical practice, these parameters are not good enough.…”

“…Electrocardiographic (ECG) parameters, such as new-onset atrial fibrillation (AF), J wave, J-point elevation, and QT interval prolongation, are considered indicators of abnormal cardiac repolarization, and somewhat valuable for predicting VT/VF. [6][7][8][9] However, in other studies and our clinical practice, these parameters are not good enough. T-peak to T-end (TpTe) interval further indicates the repolarization difference between the epicardium and endocardium.…”

Dynamicity of J waves during coronary intervention and angiography in a patient with non‐Q inferior myocardial infarction

“…Recently, J waves have been reported in relation to myocardial ischemia or VF [7–10] and demonstrated to be a useful predictor of myocardial ischemia or ventricular tachyarrhythmias. As to their mechanism, J waves, the slurs or notches at the terminal portion of the QRS complexes, can represent a conduction delay [11,13]. In a previous report [11], we observed a high prevalence of J waves in post‐MI patients, and the J wave amplitudes in these patients were augmented at a higher heart rate, suggesting a tachycardia‐dependent augmentation.…”

“…As to their mechanism, J waves, the slurs or notches at the terminal portion of the QRS complexes, can represent a conduction delay [11,13]. In a previous report [11], we observed a high prevalence of J waves in post‐MI patients, and the J wave amplitudes in these patients were augmented at a higher heart rate, suggesting a tachycardia‐dependent augmentation.…”

“…J waves are electrocardiographic findings defined as slurs or notches at the terminal portion of the QRS complexes in contiguous leads (42), with an amplitude4 0.1 mV from the electric baseline [1,2]. Recent studies have confirmed that J waves are closely related to ventricular fibrillation (VF) or sudden cardiac death [2][3][4][5][6] and found in ischemic heart diseases [7][8][9][10][11]. Whether J wave is due to a repolarization abnormality or depolarization is controversial.…”