Electrocardiographic early repolarization characteristics and clinical presentations in the young: a benign finding or worrisome marker for arrhythmias. (21st September 2016)

• Record Type: Journal Article
• Authors: Safa, Raya; Thomas, Ronald; Karpawich, Peter P.
• Is Part Of: Congenital heart disease. Volume 12:Number 1(2017)
• Page Start: 99
• Page End: 104
• Publication Date: 2016-09-21
• Subjects: arrhythmias -- early repolarization -- sudden death -- tachycardia; Congenital heart disease -- Periodicals; 616.1204305
• DOI: 10.1111/chd.12410
• Languages: English
• ISSNs: 1747-079X

Abstract

Abstract: Background: The early ECG repolarization QRS pattern (ERp), with J‐point elevation of 0.1 mV in two contiguous inferior and/or lateral leads, can be associated with ventricular arrhythmias among adults. The significance of an ERp in the young is unknown. Objective: The purpose of this study was to assess the prevalence of ERp among young patients (pts), describe and correlate the characteristics with clinical presentations and any arrhythmias. Methods: This was a 1 y retrospective review of ECGs obtained from patients referred specifically for documented arrhythmias, possible arrhythmia‐related symptoms or sports clearance. ECGs were analyzed for ERp (J‐point, ascending/horizontal patterns, location) and correlated with presenting complaints. Results: Of 301 patient ECGs, an ERp was found in 177 (59%), (pts age 11.7 ± 4.3 y); 54% male; 23% Caucasian. Of these, 6 pts had a family history of sudden cardiac death. Arrhythmias (72% atrial) occurred in 22 pts. Only 3 pts had ventricular arrhythmias (1 successfully ablated). The ascending ST segment and elevated J‐point occurred in 77% and 51% of pts with and without arrhythmias respectively. In 73% of all pts, the ERp location was in inferior/lateral leads. Neither gender, ethnicity, large J‐point, lead location, nor the combination of a horizontal ST segment with large J‐point correlated with any arrhythmias. Conclusions: ERp, especially the diffuse ascending pattern, is common among the young, in those of European ethnicity, found equally in both genders, and with no apparent correlation with atrial nor ventricular arrhythmias.