Abstract 17371: Early Repolarization ECG Pattern and Sudden Arrhythmic Death in Subjects With and Without Other ECG Markers of Cardiac Disease
Background: Inferior early repolarization ECG pattern (ER) has been associated with increased risk of sudden arrhythmic death (SAD) in general population. The ER ECG pattern is also associated with ECG markers of cardiac disease. We studied the prognosis of ER ECG pattern in subjects with and without other ECG markers of cardiac disease.
Methods and Results: The study population consisted of 10,864 subjects (52% male; mean age, 44.0±8.5 years). The mean follow up was 30 ± 11 years. The major end point was SAD according to CAST criteria. Subjects with ER ECG pattern with Q-waves and/or QRS-axis deviation (axis outside of 0°-90°) and/or QRS duration ≥ 120ms were classified as ER ECG pattern with QRS abnormalities (ER QRS+) and all other subjects as ER ECG pattern without QRS abnormalities (ER QRS-). The prevalence of inferior ER QRS+ was 4.5% and inferior ER QRS- 3.1%. Subjects with ER QRS- had an increased risk of SAD (HR 2.11; 95%CI: 1.38-3.21, p= 0.001), but subjects with ER, QRS+ were not at increased risk (HR 1.40; 95%CI: 0.92-2.11, p= 0.114). The SAD risk further increases among subjects with inferior ER QRS- pattern subjects when the J-point elevation was ≥ 0.2mV (HR 8.31; 95%CI: 3.10-22.3, p< 0.001), but remained non-significant among subjects with inferior ER QRS+. The results remain significant even after adjustment to baseline factors (age, gender, body mass index, history of smoking, systolic blood pressure and prior cardiovascular disease).
Conclusion: Inferior ER ECG pattern without other ECG markers of cardiac disease is associated with increased risk of SAD. Thus inferior ER ECG pattern seems to be an independent marker of SAD risk rather than a surrogate marker of cardiac disease in general population.
- © 2013 by American Heart Association, Inc.