Ischemia-Induced Prominent J Waves in a Patient with Brugada Syndrome

Abstract

A 75-year-old man was admitted to our hospital in January 2010 for evaluation of syncope and abnormal ECG. ECG showed type 1 ST elevation in lead V1 and he was diagnosed as Brugada syndrome. During cardiac catheterization, baseline coronary angiography was normal, but intracoronary ergonovine maleate induced spasms of the right and left coronary arteries concomitant with chest pain and ST elevation on ECG. J waves were accentuated or newly developed. Soon after an intracoronary injection of nitroglycerin, chest pain was relieved and ischemia-induced J wave disappeared and the ST segment returned to the same morphology as baseline. Extrastimuli induced ventricular fibrillation. He received an implantable cardioverter-defibrillator. He was also treated with Ca antagonist and isosorbide dinitrate and has had an uneventful course for 5 months.

Early Repolarization and Its Modification by Preexcitation in Two Patients with Intermittent Wolff‐Parkinson‐White Syndrome

“…ER or J waves is now confirmed to be a risk for ventricular fibrillation or sudden cardiac death, the same as in Brugada syndrome, 16 idiopathic ventricular fibrillation, 6–11 and ischemic heart disease 17–19 . The significance of J wave in WPW syndrome is to be elucidated 20…”

Acute Myocardial Infarction with a Left Main Trunk Lesion and Documented Lambda-like J Waves

“…In addition, the excessive ST segment elevation in I, aVL, V1-V6 may also be explained by the LMT stenosis, as well as the severe delay in the LAD. Recently, an association between J waves and myocardial ischemia has also been reported (9,23,24). According to those reports, the global ischemia induced by the right coronary artery (RCA) and/or left coronary artery (LCA) tended to generate J waves mainly in the inferolateral leads and rarely in the precordial leads.…”

Genetics of inherited primary arrhythmia disorders

“…The diagnosis of ERS is made when the ECG features of ER are noted in an individual with a history of idiopathic ventricular fibrillation or polymorphic ventricular tachycardia ( Table 6 ). 115 Other conditions known to cause J-point elevation, such as ischemia, 201 hypokalemia, 202 hypercalcemia, 203 and hypothermia, 204 need to be excluded.…”