Abstract 5677: J-Point Elevation and ST-Segment Elevation in Leads Other Than V1-V3 in Ostensibly Healthy Individuals: Innocent Findings or Markers of Arrhythmic Risk?
OBJECTIVES. To determine if J-point elevation is a marker of arrhythmic risk.
BACKGROUND. J-point elevation is considered an innocent finding among healthy young individuals (the “early repolarization” pattern). On the other hand, this electrocardiogram (ECG) finding is increasingly being associated with idiopathic ventricular fibrillation (VF).
METHODS. In a case-control study, the ECG of 45 patients with idiopathic VF were compared to those of 124 age- and gender-matched controls and to those of 121 young athletes. We measured the height of J-point and ST-segment elevation and counted the presence of slurring in the terminal portion of the R-wave.
RESULTS. J-point elevation was more common among patients with idiopathic VF than among matched-controls (42% vs. 13%, p=0.001). This was true for J-point elevation in the inferior leads (27% vs. 8%, p=0.006), and for J-point elevation in leads I-aVL (13% vs. 1%, p=0.009). J-point elevation in V4–V6 occurred with equal frequency among patients and matched-controls (6.7% vs. 7.3%, p=0.86). Males had J-point elevation more often than females and young athletes had J-point elevation more often than healthy adults but less often than patients with idiopathic VF. The presence of ST-segment elevation or QRS slurring did not add diagnostic value to the presence of J-point elevation.
CONCLUSIONS. J-point elevation is found more frequently among patients with idiopathic VF than among healthy controls. The frequency of J-point elevation among young athletes is intermediate (higher than among healthy adults but lower than among patients with idiopathic VF).