Abstract 13145: Early Repolarization Pattern is Associated with Ventricular Fibrillation in Patients with Acute Myocardial Infarction
Background: For years early repolarization (ER) has been considered as a benign electrocardiographic finding. However, recent reports show that ER is associated with a higher incidence of ventricular fibrillation (VF) and sudden cardiac death in patients without structural heart disease. Sporadic case studies have pointed out that ER might be related to an adverse outcome in patients with chronic coronary artery disease. The aim of the present study is to evaluate the incidence of ER in patients with acute myocardial infarction complicated by ventricular fibrillation.
Patients and methods: The study population consisted of 60 patients (83% males; mean age 62 +/- 12 years) with acute myocardial infarction. 30 patients (83% males; mean age 62 +/- 12 years)had documented VF during myocardial infarction and were successfully resuscitated before hospital admission. The control group consisted of 30 patients (83% males; mean age 62 +/- 13 years) with myocardial infarction without ventricular tachyarrhythmias. 12-lead ECGs were analyzed for ER, defined as J-point elevation ≥ 0.1 mV. Furthermore, ER was classified as “notching” and “slurring” of the terminal part of the QRS complex in at least two lateral or inferior leads.
Results: In 18 out of 60 patients with acute myocardial infarction ER pattern was observed. Mean elevation of the J-point was 0,165 +/- 0,07 mV. “Notching” of the J-wave was observed in 12/18 patients and “slurring” in 6/18 patients. ER was more common in patients with myocardial infarction complicated by ventricular fibrillation as compared to patients with myocardial infarction without ventricular tachyarrhythmias (47% vs. 13%, p=0.005). There have been no statistic differences in the distribution of ER in the 12-lead ECG (inferior 33% vs. lateral 39% vs. global 28%; p>0.05).
Conclusion: Early repolarization pattern is associated with ventricular tachyarrhythmias in the setting of acute myocardial infarction. Thus, ER seems to be a risk factor for ventricular fibrillation in patients with acute myocardial infarction.
- © 2011 by American Heart Association, Inc.