BACKGROUND: Early repolarization (ER) and acute ST segment elevation myocardial infarction (STEMI) are sharing the pathophysiology of J wave syndromes. It is speculated that early ventricular arrhythmias (VAs) during STEMI may be predisposed by ER. Our aim was to study the association between ER pattern and risk of VAs during acute STEMI. METHODS: The study included 102 male patients with acute STEMI who were divided into two groups: cases and controls. Cases included 52 patients with sustained VAs during the first 48 hours from the onset of STEMI, while controls included 50 patients with no VAs. On 12-lead surface electrocardiogram, ER was defined as ≥ 1 mm elevation of J point in at least two inferior or lateral leads with or without ST segment elevation. RESULTS: Mean age was 48.44 ± 10.08 years and mean left ventricular ejection fraction (LVEF) was 42.25 ± 11.1%. ER pattern was more frequent in cases than controls (29 vs 14 patients, P = 0.008). Notched J wave (P = 0.0007) and horizontal ST segment (P = 0.033) were more frequent in cases than controls. On adjusted regression model, LVEF (OR: 0.95, 95% CI: 0.91-0.99, P = 0.015) and ER (OR: 3.39, 95% CI: 1.41-8.12, P = 0.006) could predict VAs, while QTc interval (P = 0.24) and QTd (P = 0.86) did not have predictive effect. Inferior/inferolateral and global ER pattern (P = 0.044 and 0.031 respectively), notched J wave (P = 0.001), increasing J wave amplitude (P = 0.042), and ST segment elevation (P = 0.001) were associated with a higher risk of VAs. CONCLUSIONS: ER is associated with increased risk of VAs in the setting of acute STEMI.
BACKGROUND: Early repolarization (ER) and acute ST segment elevation myocardial infarction (STEMI) are sharing the pathophysiology of J wave syndromes. It is speculated that early ventricular arrhythmias (VAs) during STEMI may be predisposed by ER. Our aim was to study the association between ER pattern and risk of VAs during acute STEMI. METHODS: The study included 102 male patients with acute STEMI who were divided into two groups: cases and controls. Cases included 52 patients with sustained VAs during the first 48 hours from the onset of STEMI, while controls included 50 patients with no VAs. On 12-lead surface electrocardiogram, ER was defined as ≥ 1 mm elevation of J point in at least two inferior or lateral leads with or without ST segment elevation. RESULTS: Mean age was 48.44 ± 10.08 years and mean left ventricular ejection fraction (LVEF) was 42.25 ± 11.1%. ER pattern was more frequent in cases than controls (29 vs 14 patients, P = 0.008). Notched J wave (P = 0.0007) and horizontal ST segment (P = 0.033) were more frequent in cases than controls. On adjusted regression model, LVEF (OR: 0.95, 95% CI: 0.91-0.99, P = 0.015) and ER (OR: 3.39, 95% CI: 1.41-8.12, P = 0.006) could predict VAs, while QTc interval (P = 0.24) and QTd (P = 0.86) did not have predictive effect. Inferior/inferolateral and global ER pattern (P = 0.044 and 0.031 respectively), notched J wave (P = 0.001), increasing J wave amplitude (P = 0.042), and ST segment elevation (P = 0.001) were associated with a higher risk of VAs. CONCLUSIONS: ER is associated with increased risk of VAs in the setting of acute STEMI.
Authors: Jani T Tikkanen; Olli Anttonen; M Juhani Junttila; Aapo L Aro; Tuomas Kerola; Harri A Rissanen; Antti Reunanen; Heikki V Huikuri Journal: N Engl J Med Date: 2009-11-16 Impact factor: 91.245
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Authors: Michel Haïssaguerre; Stéphanie Chatel; Frederic Sacher; Rukshen Weerasooriya; Vincent Probst; Gildas Loussouarn; Marc Horlitz; Ruedige Liersch; Eric Schulze-Bahr; Arthur Wilde; Stefan Kääb; Joseph Koster; Yoram Rudy; Hervé Le Marec; Jean Jacques Schott Journal: J Cardiovasc Electrophysiol Date: 2009-01
Authors: Michel Haïssaguerre; Nicolas Derval; Frederic Sacher; Laurence Jesel; Isabel Deisenhofer; Luc de Roy; Jean-Luc Pasquié; Akihiko Nogami; Dominique Babuty; Sinikka Yli-Mayry; Christian De Chillou; Patrice Scanu; Philippe Mabo; Seiichiro Matsuo; Vincent Probst; Solena Le Scouarnec; Pascal Defaye; Juerg Schlaepfer; Thomas Rostock; Dominique Lacroix; Dominique Lamaison; Thomas Lavergne; Yoshifusa Aizawa; Anders Englund; Frederic Anselme; Mark O'Neill; Meleze Hocini; Kang Teng Lim; Sebastien Knecht; George D Veenhuyzen; Pierre Bordachar; Michel Chauvin; Pierre Jais; Gaelle Coureau; Genevieve Chene; George J Klein; Jacques Clémenty Journal: N Engl J Med Date: 2008-05-08 Impact factor: 91.245