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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]
In 2000 the MMRI research team uncovered evidence linking Sudden Infant Death Syndrome to a congenital heart defect, the Long QT syndrome (LQTS) published in The New England Journal of Medicine. That year they also found experimental evidence, confirmed by later research, [ citation needed ] that some forms of early repolarization could result ...
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Early repolarization syndrome, Mixed sodium channel disease, Short QT syndrome, Idiopathic ventricular fibrillation (IVF) Structural heart disease: Arrhythmogenic right ventricular cardiomyopathy (ARVC), Dilated cardiomyopathy (DCM), Hypertrophic cardiomyopathy (HCM), Wolff-Parkinson-White Syndrome (WPW), Mitral valve prolapse (MVP) Risk factors
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
J waves or Osborn waves, which represent an early repolarization and delayed depolarization of the heart ventricles, are thought to be caused by the high catecholamines surge released in patients with subarachnoid hemorrhage or brain damage, the issue that might lead to ventricular fibrillation and cardiac arrest in unmanaged patients. [39] [40]
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]
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%.