Abstract 9478: Malignant Early Repolarisation is Relatively Frequent in Young Athletes
Background: early repolarisation in infero-lateral leads (ER), a common ECG pattern in athletes, has been recently linked with an increased risk of cardiac death. Some phenotypes of ER seems to be more “malignant”: J waves in inferior leads with horizontal/descending ST pattern particularly with J wave amplitude > 2 mm. The aim of this study was to assess the proportion of “malignant” ER in a cohort of young athletes.
Methods: ECG was analysed as part of a prospective study about the impact of cardiovascular screening with ECG in young (14-35 years) athletes. ER was defined as J point elevation ≥ 1 mm in 2 or more contiguous leads (except V1-V3). Following features were noted: localisation of ER (inferior, lateral or infero-lateral), amplitude of J point, morphology of J wave (notch, slurred or indeterminate), ST segment pattern (ascending, horizontal/descending).
Results: ECG of 1070 athletes (75 % males, age 19.7 ± 6.3 years) was analysed. An ER pattern was present in 383 athletes (36 %). Localisation of ER was infero-lateral in 40%, lateral in 32 % and inferior in 28%. Maximal amplitude of J point was ≥ 2 mm in 25 % of ER pattern. The morphology of J wave was notch in 55 %, slurred in 26 % and indeterminate in 19 %. The ST segment was ascending in 77 % and horizontal/descending in 23 %. ER with a horizontal/descending ST pattern in inferior leads (“malignant” ER) represented 23 % of total ER and was present in 8 % of athletes, with J wave amplitude > 2 mm in 2 % of athletes (5% of total ER). No athlete with ER suffered from syncope of undetermined origin or had family history of premature sudden death.
Conclusions: ER in young athletes is generally characterised by a notch J wave in lateral leads with ascending ST pattern. The “malignant” phenotype is however relatively frequent. This should be take into account before drawing premature conclusion about risk stratification in this young healthy population.
- © 2012 by American Heart Association, Inc.