The early repolarization normal variant electrocardiogram: correlates and consequences

Klatsky, Arthur L.; Oehm, Rudolph; Cooper, Robert; Udaltsova, Natalia; Armstrong, Mary Anne

doi:10.1016/s0002-9343(03)00355-3

Cited by 299 publications

(154 citation statements)

References 31 publications

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“…While the prevalence of early repolarization in the general population varies between 1–5% 13,14 , some specific populations have been shown to have higher rates of this ECG finding. It has more commonly been seen in men and young persons (up to 27.5%) 34 .…”

Section: Discussionmentioning

confidence: 99%

“…Severe bradycardia was defined as < 50 bpm. Early repolarization was defined as an elevation of the J point ≥1mm compared to the baseline accompanied by a positive T wave with upward concavity in at least two adjacent leads 13,14 .…”

Section: Methodsmentioning

confidence: 99%

“…Sinus bradycardia has also been associated with the common electrocardiographic finding of early repolarization 13,14 . Early repolarization affects 1–5% of the general population and was long considered to be a benign condition 13,14 .…”

Section: Introductionmentioning

confidence: 99%

“…Early repolarization affects 1–5% of the general population and was long considered to be a benign condition 13,14 . However, recent clinical studies have shown that patients with this type of ECG pattern are at increased risk of ventricular fibrillation (VF) 15,16 .…”

Section: Introductionmentioning

confidence: 99%

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Bradycardia as a Marker of Chronic Cocaine Use: A Novel Cardiovascular Finding

Sharma

Rathnayaka

Green

et al. 2014

Behavioral Medicine

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Background Few studies have examined the effects of chronic cocaine use on the resting surface electrocardiogram (ECG) between exposures to cocaine. Methods 12-lead ECGs from 97 treatment-seeking cocaine-dependent subjects were compared to ECG parameters from 8513 non-cocaine-using control subjects from the Atherosclerosis Risk in Communities study. Results After matching and adjusting for relevant covariates, cocaine use demonstrated large and statistically reliable effects on early repolarization, bradycardia, severe bradycardia, and heart rate. Current cocaine dependence corresponds to an increased odds of demonstrating early repolarization by a factor of 4.92 and increased odds of bradycardia and severe bradycardia by factors 3.02 and 5.11, respectively. Conclusion This study demonstrates the novel finding that long-lasting effects of cocaine use on both the cardiac conduction and the autonomic nervous system pose a risk of adverse cardiovascular events between episodes of cocaine use, and that bradycardia is a marker of chronic cocaine use.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bradycardia as a Marker of Chronic Cocaine Use: A Novel Cardiovascular Finding

Sharma

Rathnayaka

Green

et al. 2014

Behavioral Medicine

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“…Early repolarization (ER), which is characterized by an elevation of the junction between the end of the QRS complex and the beginning of the ST segment (J-point) from baseline on a standard 12-lead electrocardiography (ECG), has commonly been regarded as a benign finding 1,2. However, recent data demonstrated an association between ER in the inferior leads and fatal arrhythmias or sudden cardiac death in patients without structural heart diseases 3,4,5,6,7…”

Section: Introductionmentioning

confidence: 99%

Early Repolarization and Myocardial Scar Predict Poorest Prognosis in Patients with Coronary Artery Disease

Lee

Mun

et al. 2014

Yonsei Med J

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PurposeRecent studies show positive association of early repolarization (ER) with the risk of life-threatening arrhythmias in patients with coronary artery disease (CAD). This study was to investigate the relationships of ER with myocardial scarring and prognosis in patients with CAD.Materials and MethodsOf 570 consecutive CAD patients, patients with and without ER were assigned to ER group (n=139) and no ER group (n=431), respectively. Myocardial scar was evaluated using cardiac single-photon emission computed tomography.ResultsER group had previous history of myocardial infarction (33% vs. 15%, p<0.001) and lower left ventricular ejection fraction (57±13% vs. 62±13%, p<0.001) more frequently than no-ER group. While 74 (53%) patients in ER group had myocardial scar, only 121 (28%) patients had in no-ER group (p<0.001). During follow up, 9 (7%) and 4 (0.9%) patients had cardiac events in ER and no-ER group, respectively (p=0.001). All patients with cardiac events had ER in inferior leads and horizontal/descending ST-segment. Patients with both ER in inferior leads and horizontal/descending ST variant and scar had an increased adjusted hazard ratio of cardiac events (hazard ratio 16.0; 95% confidence interval: 4.1 to 55.8; p<0.001).ConclusionER in inferior leads with a horizontal/descending ST variant was associated with increased risk of cardiac events. These findings suggest that ER in patients with CAD may be related to myocardial scar rather than pure ion channel problem.

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The ECG in Other Heart Diseases

Luna

2012

Clinical Electrocardiography

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The early repolarization normal variant electrocardiogram: correlates and consequences

Cited by 299 publications

References 31 publications

Bradycardia as a Marker of Chronic Cocaine Use: A Novel Cardiovascular Finding

Bradycardia as a Marker of Chronic Cocaine Use: A Novel Cardiovascular Finding

Early Repolarization and Myocardial Scar Predict Poorest Prognosis in Patients with Coronary Artery Disease

The ECG in Other Heart Diseases

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