In 1936 early repolarization (ER) was 1st described as ST-segment elevation in the absence of coronary artery disease, typically viewed as a benign ECG finding (BER) not association with increased cardiovascular mortality
Classically the prevalence of BER tends to be associated with young athletes, male sex, and black race
Recent data from Haissaguerre et al. and Tikkanen et al. suggest that certain subtypes of ER may be associated with a predisposition for malignant arrhythmias and sudden cardiac death (SCD)
Although ER has various definitions contingent on the author, it consists of two components:
1.) Prominent J wave
2.) ST-segment elevation
This article (9/13 JACC) focuses on the analysis and importance of the ST-segment contour and its possible relation to “malignant” repolarization
Several studies (subgroup analysis) have found that a rapidly ascending ST-segment blending with the T-wave (Figures: A & C) confers BER, whereas a flat, horizontal, or even descending ST-segment (Figures: B & D) prior to the T-wave has potential to be malignant
*Please see the attachment below for Figures A-D
References
1. Adler A, Rosso R, Viskin D, et al. JACC. Sept. 2013: Vol. 62(10) pgs. 863-868 2. Haissaguerre M., Derval N., Sacher F., et al: Sudden cardiac arrest associated with early repolarization. N Engl J Med 2008; 358: 2016-2023 3. Tikkanen J.T., Anttonen O., Junttila M.J., et al: Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med 2009; 361: 2529-2537
