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- In 1936 early repolarization (ER) was 1st described as ST-segment elevation in the absence of coronary artery disease, typically viewed as a benign ECG finding (BER) not association with increased cardiovascular mortality
- Classically the prevalence of BER tends to be associated with young athletes, male sex, and black race
- Recent data from Haissaguerre et al. and Tikkanen et al. suggest that certain subtypes of ER may be associated with a predisposition for malignant arrhythmias and sudden cardiac death (SCD)
- Although ER has various definitions contingent on the author, it consists of two components:
- 1.) Prominent J wave
- 2.) ST-segment elevation
- This article (9/13 JACC) focuses on the analysis and importance of the ST-segment contour and its possible relation to “malignant” repolarization
- Several studies (subgroup analysis) have found that a rapidly ascending ST-segment blending with the T-wave (Figures: A & C) confers BER, whereas a flat, horizontal, or even descending ST-segment (Figures: B & D) prior to the T-wave has potential to be malignant
*Please see the attachment below for Figures A-D
References
1. Adler A, Rosso R, Viskin D, et al. JACC. Sept. 2013: Vol. 62(10) pgs. 863-868
2. Haissaguerre M., Derval N., Sacher F., et al: Sudden cardiac arrest associated with early repolarization. N Engl J Med 2008; 358: 2016-2023
3. Tikkanen J.T., Anttonen O., Junttila M.J., et al: Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med 2009; 361: 2529-2537