Abstract 8773: Aborted Sudden Cardiac Death in Patients with Early Repolarization on Electrocardiography in Japanese Population
Background: It is well known that an early-repolarization (ER) pattern in the inferior or lateral precordial leads is associated with ventricular fibrillation (VF). This study aimed to investigate the characteristics of the ER pattern during electrocardiography in resuscitated cardiopulmonary arrest (CPA) patients.
Methods: This study included 1,951 consecutive CPA patients who were carried in our emergency room between January 2009 and June 2010. The patients were eligible for enrollment, if they had experienced an unexplained cardiac arrest (with documented cardiovascular collapse with ventricular tachycardia or VF) that required cardiopulmonary resuscitation to restore sinus rhythm. The ER patterns were evaluated for the presence of early repolarization in the inferior and lateral leads. Early-repolarization patterns were stratified according to the degree of the J-point elevation (≥ 0.1 mV or > 0.2 mV) that was either notched (a positive J deflection inscribed on the S wave) or slurred (a smooth transition from QRS to ST-segment) in at least two consecutive inferior or lateral leads.
Results: Forty-one patients were successfully resuscitated. ST elevation of more than 0.1mV was observed in 17 patients (41%), (mean age = 61 ± 20 years, 3 female): 14 (34%) in the inferior leads and 3 (7%) in the lateral leads. In these subjects, 10 had structural heart disease (group-S) and 7 were diagnosed with ER syndrome (group-ER). A slurred J-point elevation was more often recorded in group-ER and notched J-point elevation more often in group-S (p < 0.05). Further, the magnitude of the J-point elevation was significantly higher in group-ER than in group-S (1.7 ± 0.6 vs. 1.2 ± 0.3 mV, p < 0.05). The degree of the slurred J-point elevation decreased two days after hospitalization in group-ER. There were no significant differences in the other parameters between the two groups.
Conclusion: A slurred and higher J-point elevation might be associated with increased risk of sudden cardiac death in ER syndrome.
- © 2011 by American Heart Association, Inc.