Early repolarization pattern is associated with ventricular fibrillation in patients with acute myocardial infarction

Rudic, Boris; Veltmann, Christian; Kuntz, Esther; Behnes, Michael; Elmas, Elif; Konrad, Torsten; Kuschyk, Jürgen; Weiß, Christel; Borggrefe, Martin; Schimpf, Rainer

doi:10.1016/j.hrthm.2012.03.006

Cited by 84 publications

(61 citation statements)

References 27 publications

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“…The concept has now expanded to include other structural heart diseases such as acute myocardial infarction, variant angina and even some forms of cardiomyopathy. [9][10][11][12][13][14] This highlights the possibility that J waves may be even more important than previously recognized and may serve as a common mechanism of ventricular fibrillation (VF) in various clinical settings. This review describes the electrocardiographic features and basic electrophysiologic mechanisms underlying these J wave-related VF syndromes.…”

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confidence: 99%

Idiopathic Ventricular Fibrillation, Early Repolarization and Other J Wave-Related Ventricular Fibrillation Syndromes

Nam

2012

Circ J

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Current clinical and experimental data demonstrate that the electrocardiographic J wave plays a critical role in the pathogenesis of ventricular fibrillation (VF) in patients with Brugada syndrome (BS) and early repolarization (ER) syndrome (ERS). This has generated renewed interest in the presence of J waves and ERS in the general population, yet the identification of high-risk ECG markers and the risk stratification of subjects with ERS remain to be established. More recently, this concept has been expanded to VF mechanisms in patients with structural heart diseases. Some of the fatal arrhythmias in the setting of acute myocardial ischemia or infarction may share a similar, J wave-related electrophysiologic process. In canine arterially perfused wedge preparations, the occurrence of J waverelated arrhythmias is mediated by phase 2 reentry. The stability of the action potential (AP) dome in the ventricular epicardium is dependent on the prominence of the AP phase 1 notch. The ability to maintain the AP dome depends on a delicate balance between inward and outward ionic currents during depolarization and the early phase of repolarization. Outward shifts of the balance and inability to maintain the AP dome result in marked dispersion of repolarization and vulnerability to VF. This review describes the electrocardiographic and clinical features of the J waves in idiopathic VF and other structural heart diseases. (Circ J 2012; 76: 2723 - 2724NAM GB cardioverter defibrillator (ICD) implantation at the Asan Medical Center, Korea. Structural diseases were present in 209 (68%) of 309 ICD recipients. Coronary artery disease or myocardial infarction, and hypertrophic cardiomyopathy were underlying cardiac diseases in approximately 40% of all ICD recipients. Other structural cardiac abnormalities (dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, sarcoidosis, valvular or congenital heart diseases) were present in 28% of these cases. Among the 100 patients without structural heart diseases, long QT syndrome (LQTS), BS and ERS were identified in 10 (3.2%), 29 (9.4%) and 16 (5.2%) of the patients, respectively. After extensive search for an underlying etiology, the diagnosis remained idiopathic in 45 patients (14.5%). Interestingly, after careful review of all the ECGs taken during peri-event periods, provocation, and at the outpatient clinic, a significant proportion (19/45, 42.2%) of the patients whose diagnosis was presumed to be idiopathic showed a J wave fluctuation, which did not satisfy the diagnostic criteria of either BS or ERS. These patients are described later in the section about J wave-related VF syndrome in the absence of structural heart disease (IVF-J). In 26 patients, abnormal findings were not identified in any of the ECGs, and these cases were termed true "idiopathic VF (IVF)". BSBS is the prototype of cardiac ion-channel diseases, and has opened a new era in translational electrophysiology. It is characterized by unique ECG changes of coved-type J/ST/T waves, and a high risk of ...

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confidence: 99%

Idiopathic Ventricular Fibrillation, Early Repolarization and Other J Wave-Related Ventricular Fibrillation Syndromes

Nam

2012

Circ J

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“…7 In Rudic et al's prospective case-control study, ERP was reported to be associated with VF in 60 patients with STEMI or non-STEMI. 8 And, in Ali Diab et al's case-control study with 102 male STEMI patients, ERP was reported to be associated with sustained VT and VF. 9 In Park et al's study of STEMI patients who accepted PCI were enrolled consecutively, ERP was reported to be associated with atrial arrhythmia and VT (nonsustained VT was included) and VF, 10 while in Ozcan et al's study of prospectively enrolled STEMI patients who accepted PCI, ERP was associated with in-hospital and long-term death.…”

Section: Association Between Erp and Vt/vf In Patients With Stemimentioning

confidence: 98%

Early Repolarization Pattern Predicts the Increased Risk of Ventricular Arrhythmias in Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction　― A Propensity Analysis ―

Chen¹,

Zheng

Liu

et al. 2017

Circ J

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“…In acute STEMI, ER has been found to be associated with a significant increase in risk of ventricular tachyarrhythmia in the acute post infarction phase (<72 hours), irrespective of left ventricular function and level of cardiac enzyme rise. 20,21 In patients with known chronic coronary artery disease, ventricular arrhythmia has been found to be more common in those with inferior early repolarisation; additionally, the presence of associated notching was also strongly associated with risk. 22 Further validation is required before ER can be employed in this setting.…”

Section: Key Pointsmentioning

confidence: 99%

New approaches to predicting the risk of sudden death

Behr

Ensam

2016

Clinical Medicine

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In this review article, we will explore some of the contemporary methods for predicting sudden cardiac death (SCD). These include experimental methods yet to be adopted in the clinical setting, and methods that have been extrapolated from observational data in those with a history of SCD. We will discuss how these relate to the different aetiologies and disease processes. We will also explore how these may be used in the clinical setting to decide on management.

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Early repolarization pattern is associated with ventricular fibrillation in patients with acute myocardial infarction

Cited by 84 publications

References 27 publications

Idiopathic Ventricular Fibrillation, Early Repolarization and Other J Wave-Related Ventricular Fibrillation Syndromes

Idiopathic Ventricular Fibrillation, Early Repolarization and Other J Wave-Related Ventricular Fibrillation Syndromes

Early Repolarization Pattern Predicts the Increased Risk of Ventricular Arrhythmias in Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction　― A Propensity Analysis ―

New approaches to predicting the risk of sudden death

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Early repolarization pattern is associated with ventricular fibrillation in patients with acute myocardial infarction

Cited by 84 publications

References 27 publications

Idiopathic Ventricular Fibrillation, Early Repolarization and Other J Wave-Related Ventricular Fibrillation Syndromes

Idiopathic Ventricular Fibrillation, Early Repolarization and Other J Wave-Related Ventricular Fibrillation Syndromes

Early Repolarization Pattern Predicts the Increased Risk of Ventricular Arrhythmias in Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction ― A Propensity Analysis ―

New approaches to predicting the risk of sudden death

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Early Repolarization Pattern Predicts the Increased Risk of Ventricular Arrhythmias in Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction　― A Propensity Analysis ―