title: Sudden cardiac arrest associated with early repolarization.
abstract: BACKGROUND
  Early repolarization is a common electrocardiographic finding that is generally considered to be benign. Its potential to cause cardiac arrhythmias has been hypothesized from experimental studies, but it is not known whether there is a clinical association with sudden cardiac arrest.
  
  
  METHODS
  We reviewed data from 206 case subjects at 22 centers who were resuscitated after cardiac arrest due to idiopathic ventricular fibrillation and assessed the prevalence of electrocardiographic early repolarization. The latter was defined as an elevation of the QRS-ST junction of at least 0.1 mV from baseline in the inferior or lateral lead, manifested as QRS slurring or notching. The control group comprised 412 subjects without heart disease who were matched for age, sex, race, and level of physical activity. Follow-up data that included the results of monitoring with an implantable defibrillator were obtained for all case subjects.
  
  
  RESULTS
  Early repolarization was more frequent in case subjects with idiopathic ventricular fibrillation than in control subjects (31% vs. 5%, P<0.001). Among case subjects, those with early repolarization were more likely to be male and to have a history of syncope or sudden cardiac arrest during sleep than those without early repolarization. In eight subjects, the origin of ectopy that initiated ventricular arrhythmias was mapped to sites concordant with the localization of repolarization abnormalities. During a mean (+/-SD) follow-up of 61+/-50 months, defibrillator monitoring showed a higher incidence of recurrent ventricular fibrillation in case subjects with a repolarization abnormality than in those without such an abnormality (hazard ratio, 2.1; 95% confidence interval, 1.2 to 3.5; P=0.008).
  
  
  CONCLUSIONS
  Among patients with a history of idiopathic ventricular fibrillation, there is an increased prevalence of early repolarization.
authors.affiliation: Université Bordeaux, Hôpital Haut-Lévêque, Bordeaux-Pessac, France. michel.haissaguerre@chu-bordeaux.fr
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
authors.forename: Nicolas
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authors.lastname: Derval
authors.forename: Frederic
authors.initials: F
authors.lastname: Sacher
authors.forename: Laurence
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authors.lastname: Jesel
authors.forename: Isabel
authors.initials: I
authors.lastname: Deisenhofer
authors.forename: Luc
authors.initials: L
authors.lastname: de Roy
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Pasquié
authors.forename: Akihiko
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authors.lastname: Nogami
authors.forename: Dominique
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authors.lastname: Babuty
authors.forename: Sinikka
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authors.lastname: Yli-Mayry
authors.forename: Christian
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authors.lastname: De Chillou
authors.forename: Patrice
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authors.lastname: Scanu
authors.forename: Philippe
authors.initials: P
authors.lastname: Mabo
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Vincent
authors.initials: V
authors.lastname: Probst
authors.forename: Solena
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authors.lastname: Le Scouarnec
authors.forename: Pascal
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authors.lastname: Defaye
authors.forename: Juerg
authors.initials: J
authors.lastname: Schlaepfer
authors.forename: Thomas
authors.initials: T
authors.lastname: Rostock
authors.forename: Dominique
authors.initials: D
authors.lastname: Lacroix
authors.forename: Dominique
authors.initials: D
authors.lastname: Lamaison
authors.forename: Thomas
authors.initials: T
authors.lastname: Lavergne
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
authors.forename: Anders
authors.initials: A
authors.lastname: Englund
authors.forename: Frederic
authors.initials: F
authors.lastname: Anselme
authors.forename: Mark
authors.initials: M
authors.lastname: O'Neill
authors.forename: Meleze
authors.initials: M
authors.lastname: Hocini
authors.forename: Kang Teng
authors.initials: KT
authors.lastname: Lim
authors.forename: Sebastien
authors.initials: S
authors.lastname: Knecht
authors.forename: George D
authors.initials: GD
authors.lastname: Veenhuyzen
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.forename: Michel
authors.initials: M
authors.lastname: Chauvin
authors.forename: Pierre
authors.initials: P
authors.lastname: Jais
authors.forename: Gaelle
authors.initials: G
authors.lastname: Coureau
authors.forename: Genevieve
authors.initials: G
authors.lastname: Chene
authors.forename: George J
authors.initials: GJ
authors.lastname: Klein
authors.forename: Jacques
authors.initials: J
authors.lastname: Clémenty
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D054849:Cardiac Electrophysiology; D016022:Case-Control Studies; D017115:Catheter Ablation; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D018709:Statistics, Nonparametric; D014693:Ventricular Fibrillation / Q000150:complications / Q000503:physiopathology* / Q000628:therapy
chemical_list: D000889:Anti-Arrhythmia Agents