The effect of exercise on the ECG criteria for early repolarization pattern

Nouraei, H.; Rabkin, Simon W.

doi:10.1016/j.jelectrocard.2019.03.005

Cited by 8 publications

(5 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, the J wave reappeared in the post-exercise period. Similar results were reported by Nouraei et al, who investigated the effect of exercise on the ECG criteria for ERP in their study [30]. The disappearance of the J wave during exertion is probably explained by the increased sympathetic activity.…”

Section: Discussionsupporting

confidence: 91%

Exercise-Induced Electrocardiographic Changes in Healthy Young Males with Early Repolarization Pattern

Kocsis,

Pap,

László

et al. 2024

Diagnostics

View full text Add to dashboard Cite

Background: Exercise-induced modifications in ECG parameters among individuals with an early repolarization pattern (ERP) have not been evaluated in detail. We aimed to assess this phenomenon, with potential associations with arrhythmogenesis. Methods: Twenty-three young, healthy males with ERP (ERP+) participated in this study, alongside a control group, which consisted of nineteen healthy males without ERP (ERP−). ECGs at baseline, at peak exercise (Bruce protocol), and during the recovery phase were analyzed and compared between the two groups. Results: The treadmill test demonstrated strong cardiovascular fitness, with similar chronotropic and pressor responses in both groups. In the baseline ECGs, the QRS complex and the QT interval were shorter in the ERP+ group. During exercise, the P-wave duration was significantly longer and the QRS was narrower in the ERP+ group. In the recovery phase, there was a longer P wave and a narrower QRS in the ERP+ group. During the treadmill test, the J wave disappeared or did not meet the criteria required for ERP diagnosis. Conclusions: The slowed intra-atrial conduction found during exercise could be predictive of atrial arrhythmogenesis in the setting of ERP. The disappearing of J waves during exercise, due to increased sympathetic activity, has potential clinical significance.

show abstract

Section: Discussionsupporting

confidence: 91%

Exercise-Induced Electrocardiographic Changes in Healthy Young Males with Early Repolarization Pattern

Kocsis,

Pap,

László

et al. 2024

Diagnostics

View full text Add to dashboard Cite

show abstract

“…This may reflect the older age group of the cases or the dynamic nature of early repolarization changes. We have previously reported that repolarization changes are more evident at slow heart rates and less evident at faster heart rates [ 27 ]. The majority of the cases in this study did not have bradycardia.…”

Section: Discussionmentioning

confidence: 99%

“…The ECGs were reviewed for the presence of early repolarization (ER) changes. MacFarlane's consensus criteria for ER were used [ 31 ] and are briefly as follows: (i) an end-QRS notch or slur on the final 50% of the down-slope of an R wave in which the notch or the slur was above the baseline, (ii) Jp ≥ 0.1 mV in 2 or more contiguous leads of the 12-lead ECG (excluding V1–V3; to eliminate the possibility of Brugada syndrome), and (iii) QRS duration < 120 ms, as per our previous examination of early repolarization changes [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

“…In turn, early repolarization changes have been related to adverse outcomes [ 24 ], although this is controversial [ 25 , 26 ]. Early repolarization changes can be transient and are impacted by the activity and heart rate [ 27 ], and as such, it is important to utilize an appropriate heart rate correction formula to ensure that the short QT is defined appropriately.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation

Rabkin

Tang

2020

Cardiology Research and Practice

Self Cite

View full text Add to dashboard Cite

A short QT interval has been difficult to define, and there is debate whether it exists outside of an extremely small group of individuals with inherited channelopathies and whether it predicts cardiac arrhythmias. The objective was to identify cases with short QT and their consequences. Our hospital ECG database was screened for cases with a QTc based on the Bazett formula (QTcBZT) of less than 340 ms. The QTc was recalculated using the spline (QTcRBK) formula, which more accurately adjusts for the heart rate and identifies cases based on percentile distribution of the QT interval. The exclusion criteria were presence of bundle branch block, arrhythmias, or electronic pacemakers. An age- and sex-matched cohort was obtained from individuals with normal QT intervals with the same exclusion criteria. There were 28 cases with a short QTc (QTcRBK < 380 ms). The age was 69.6 ± 14.6 years (mean ± SD) (50% males). The QT interval was 305.7 ± 61.1 ms with QTcRBK 308.4 ± 31.4 ms. Subsequent ECGs showed atrial flutter in 21%, atrial fibrillation in 18%, and atrial tachycardia in 4% of cases. Thus, atrial arrhythmias occurred in 43% of cases. This incidence was significantly ( p < 0.0001 ) greater than the incidence of atrial arrhythmias in age- and sex-matched controls. In conclusion, a short QT interval can be readily identified based on the first percentile of the new QTc formula. A short QTc is an important marker for the development of atrial arrhythmias, including atrial flutter and atrial fibrillation, with the former predominating. It should be part of patient assessment and warrants consideration to develop strategies for detection and prevention of atrial arrhythmias.

show abstract

“…Variability in time includes a shortterm and a long-term proportion. The short-term variability means J wave enhancement during parasympathetic stimulation, extreme temperatures [116], bradycardia, and vice versa, J wave decrease while hyperventilating [12], or during tachycardia [12,26,118,119]. This demeanour is typical of repolarization phenomena, empowering therefore the J wave to be discriminated from a late depolarization phenomena (as, for example, the R' wave of RBBB, or the last part of a fragmented QRS), whose behaviour is antithetical (i.e., depolarization waves enlarge during tachycardia and diminish during bradycardia) [26,116].…”

Section: Congenital J Wave Syndromesmentioning

confidence: 99%

ST Segment Elevation

Lucaci¹

2022

Romanian Journal of Cardiology

View full text Add to dashboard Cite

As the earliest indirect sign of an acute coronary occlusion arriving against non-operative collateral heart vessels, the unabating ST segment elevation accounts for the acute coronary syndrome asking for mandatory and immediate reperfusion therapy. The geography of the ST segment elevations usually enables one to identify the culprit artery and to guess its likely occlusion site, as pivotal pieces of the necessary vital risk forecasting, along with somehow expected occurring arrhythmias. Aside from the classical ST segment elevation myocardial infarction (STEMI) pattern, a handful of distinctive non-ST elevation appearances of the acute coronary occlusion also need imperative reperfusion therapy, thus qualifying themselves as STEMI equivalents. The early forthcoming of ST elevation during an acute transmural ischaemic episode, as well as the wide availability of the electrocardiogram, make it an invaluable diagnostic tool. Yet many confounding factors are able to limit the diagnostic sensibility of ST elevation (as for example its customary absence in the conventional leads in some cases of circumflex artery occlusion, or the casual mutual cancellation of the transmural ST vectors from opposite ventricular walls), the accuracy of the electrocardiographic localisation of the occlusion site (due to coronary anatomic variants, concomitant new or old coronary lesions elsewhere, previous coronary artery bypass grafts), as well as its specificity for transmural ischaemia (by virtue of a well-known manifold of non-ischaemic causes). While the STEMI patient must be offered undelayed reperfusion therapy, the non-ischaemic ST elevation one should be kept away from the haemorrhagic risk of a useless invasive procedure.

show abstract

The effect of exercise on the ECG criteria for early repolarization pattern

Cited by 8 publications

References 28 publications

Exercise-Induced Electrocardiographic Changes in Healthy Young Males with Early Repolarization Pattern

Exercise-Induced Electrocardiographic Changes in Healthy Young Males with Early Repolarization Pattern

The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation

ST Segment Elevation

Contact Info

Product

Resources

About