Abstract
The early repolarization (ER) pattern is a particular EKG aspect first described in 1936 by Shipley and Hallaran as a normal variant of repolarization. Subsequently Haissaguerre et al proposed a new ER classification characterized by J point elevation associated with J wave and ST-segment elevation or a horizontal/descending ST segment. A recent meta-analysis shows that the ER pattern was associated with high risk of all-cause mortality if characterized by a notched J wave with a horizontal/descending ST elevation and T waves discordant to their respective ST-segment deviation (<0.3 % of the general population). In this chapter is described the clinical case of a 38-year-old black man admitted to the emergency room for some episodes of acute chest pain started some days ago, some days ago.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Shipley R, Hallaran W (1936) The four lead electrocardiogram in 200 normal men and women. Am Heart J 11:325–345
Haissaguerre M, Derval N, Sacher F et al (2008) Sudden cardiac arrest associated with early repolarization. N Engl J Med 358:2016–2023
Klatsky AL, Oehm R, Cooper RA et al (2003) The early repolarization normal variant electrocardiogram: correlates and consequences. Am J Med. 115(3):171–177.
Tikkanen JT, Anttonen O, Junttila MJ et al (2009) Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med 361:2529–2537
Kambara H, Phillips J (1976) Long-term evaluation of early repolarization syndrome (normal variant RS-T segment elevation). Am J Cardiol 38:157–161
Trevino A, Raza B, Beller BM (1971) The characteristic electrocardiogram of accidental hypothermia. Arch Intern Med 127:470–475
Surawicz B, Knilans TK (2008) Chou’s electrocardiography in clinical practice, 6th edn. Saunders/Elsevier, Philadelphia, p 20
Junttila MJ, Sager SJ, Freiser M, McGonagle S, Castellanos A, Myerburg RJ (2011) Inferolateral early repolarization in athletes. J Interv Card Electrophysiol 31:33–38
Goldman M (1953) RS-T segment elevation in mid-and left precordial leads as a normal variant. Am Heart J 46:817–820
Yan GX, Antzelevitch C (1996) Cellular basis for the electrocardiographic J wave. Circulation 93:372–379
Antzelevitch C, Brugada P, Borggrefe M, Brugada J, Brugada R, Corrado D, Gussak I, LeMarec H, Nademanee K, Perez Riera AR, Shimizu W, Schulze-Bahr E, Tan H, Wilde A (2005) Brugada syndrome: report of the second consensus conference: endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation 111:659–670
Veltmann C, Schimpf R, Echternach C, Eckardt L, Kuschyk J, Streitner F, Spehl S, Borggrefe M, Wolpert C (2006) A prospective study on spontaneous fluctuations between diagnostic and non-diagnostic ECGs in Brugada syndrome: implications for correct phenotyping and risk stratification. Eur Heart J 27:2544–2552
Otto CM, Tauxe RV, Cobb LA et al (1984) Ventricular fibrillation causes sudden death in Southeast Asian immigrants. Ann Intern Med 101:45–47
Tikkanen JT, Junttila MJ, Anttonen O, Aro AL, Luttinen S, Kerola T, Sager SJ, Rissanen HA, Myerburg RJ, Reunanen A, Huikuri HV (2011) Early repolarization: electrocardiographic phenotypes associated with favorable long-term outcome. Circulation 123:2666–2673
Wu SH, Lin XX, Cheng YJ, Qiang CC, Zhang J (2013) Early repolarization pattern and risk for arrhythmia death: a meta-analysis. J Am Coll Cardiol 61(6):645–650. doi:10.1016/j.jacc.2012.11.023. Epub 2013 Jan 2
Rosso R, Kogan E, Belhassen B et al (2008) J-point elevation in survivors of primary ventricular fibrillation and matched control subjects incidence and clinical significance. J Am Coll Cardiol 52:1231–1238
Myojo T, Sato N, Nimura A, Matsuo A, Taniguchi O, Nakamura H et al (2012) Recurrent ventricular fibrillation related to hypokalemia in early repolarization syndrome. Pacing Clin Electrophysiol 35:e234–e238. doi:10.1111/j.1540-8159.2012.03460.x
Kalla H, Yan GX, Marinchak R (2000) Ventricular fibrillation in a patient with prominent J (Osborn) waves and ST segment elevation in the inferior electrocardiographic leads: a Brugada syndrome variant? J Cardiovasc Electrophysiol 11:95–98
The ACC/AHA/HRS (2008) guidelines for device-based therapy of cardiac rhythm abnormalities: their relevance to the cardiologist, internist and family physician. J Invasive Cardiol 2009;21(5):234–237.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Fabbrizioli, A., Pongetti, G. (2015). Early Repolarization Pattern. In: Capucci, A. (eds) Clinical Cases in Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-19926-9_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-19926-9_6
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-19925-2
Online ISBN: 978-3-319-19926-9
eBook Packages: MedicineMedicine (R0)