The early repolarization normal variant electrocardiogram: correlates and consequences.
OBJECTIVE
We compared the characteristics and outcomes of patients with "early repolarization" electrocardiograms (ECGs) with those who had normal ECGs.


METHODS
In 1983 to 1985, we collected photocopies of 2234 selected ECGs from 73088 patients undergoing health examinations. Excluding 153 ECGs with missing data or that were judged to be abnormal, the remaining ECGs were reinterpreted in 2000 by cardiologists as showing early repolarization (n = 670), or being borderline (n = 330) or normal (n = 1081). Characteristics and outcomes of persons with early repolarization ECGs were compared with those who had normal ECGs using analysis of variance, logistic regression, or proportional hazards models. Information on exercise was available in 325 patients.


RESULTS
Patients with early repolarization were more likely to be male (81% [n = 583] vs. 33% [n = 360]), <40 years old (60% [n = 441] vs. 37% [n = 403]), black (48% [n = 384] vs. 26% [n = 280]), and more athletically active (mean [+/- SD], 10.4 +/- 1.3 hours per week of activity vs. 6.4 +/- 1.2 hours per week of activity) than those with normal ECGs. Patients with early repolarization were not more likely to be hospitalized (hazard ratio [HR] = 1.0; 95% confidence interval [CI]: 0.9 to 1.2) or to die (HR = 0.8; 95% CI: 0.6 to 1.2) during follow-up than those with normal ECGs. Outpatient diagnoses were not more common in those with early repolarization; arrhythmias were actually less common (P <0.01).


CONCLUSIONS
Although especially prevalent in young, athletic, black men, early repolarization is not rare in other patients. The long-term prognosis of early repolarization is benign.
Klatsky
Arthur L
AL
Department of Medicine, Kaiser Permanente Medical Care Program, Oakland, California 94611, USA. hartmavn@pacbell.net
Oehm
Rudolph
R
Cooper
Robert A
RA
Udaltsova
Natalia
N
Armstrong
Mary Anne
MA
D000328:Adult; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D006321:Heart / Q000502:physiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D010809:Physical Fitness; D015995:Prevalence; D044469:Racial Groups; D012016:Reference Values; D012307:Risk Factors; D017678:Sex Distribution