The early repolarization variant--normal or a marker of heart disease in certain subjects.

The theory is advanced that the early repolarization variant may not always be benign and that it can become a substrate for ventricular arrhythmias, sudden death, and hypercontractility cardiomyopathy in some subjects, including certain high-performance athletes. In addition, it is suggested that it likely represents part of a spectrum of cardiovascular anomalies related to nonischemic ST elevation including Brugada syndrome, and that it may also have a molecular genetic origin of variable penetrance.