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Research in the late 2000s has linked this finding to ventricular fibrillation, particularly in those who have fainted or have a family history of sudden cardiac death. [5] [6] [7] Although there is a significant relationship between ventricular fibrillation and some early repolarization's patterns, the overall lifetime occurrence of idiopathic ventricular fibrillation is exceptionally rare. [8]
de Winter syndrome is an electrocardiogram (ECG) pattern which often represents sudden near blockage of the left anterior descending artery (LAD). [1] [5] Symptoms include chest pain, shortness of breath, and sweating. [1] While typically due to blockage of the LAD, other arteries of the heart may be involved. [1]
The clinician must therefore be well versed in recognizing the so-called ECG mimics of acute myocardial infarction, which include left ventricular hypertrophy, left bundle branch block, paced rhythm, early repolarization, pericarditis, hyperkalemia, and ventricular aneurysm. [7] [8] [9] Localisation of the occlusion in the ECG showing STEMI changes
Long QT syndrome (LQTS), Brugada syndrome, CPVT (catecholaminergic polymorphic ventricular tachycardia), PCCD (progressive cardiac conduction defect), Early repolarization syndrome, Mixed sodium channel disease, Short QT syndrome, Idiopathic ventricular fibrillation (IVF) Structural heart disease: Arrhythmogenic right ventricular cardiomyopathy ...
Early repolarization usually occurs in young males (age <40 years) and ECG changes are characterized by terminal R-S slurring, temporal stability of ST-deviations and J-height/ T-amplitude ratio in V5 and V6 of <25% as opposed to pericarditis where terminal R-S slurring is very uncommon and J-height/ T-amplitude ratio is ≥ 25%.
Long QT syndrome, Brugada syndrome, Andersen-Tawil syndrome, Early repolarization syndrome: Treatment: Avoidance of strenuous exercise, medication, implantable cardioverter defibrillator [2] Medication: Beta-adrenoceptor blockers, Verapamil, Flecainide [2] Prognosis: 13–20% life threatening arrhythmias over 7–8 years [3] Frequency: 1:10,000 [4]
A mutation in KCNJ8 has been associated with cardiac arrest in the early repolarization syndrome. Potassium channels are present in most mammalian cells, where they participate in a wide range of physiologic responses. K ir 6.1 is an integral membrane protein and inward-rectifier type potassium channel.
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