title: Early repolarization pattern is associated with ventricular fibrillation in patients with acute myocardial infarction.
abstract: BACKGROUND
  For years early repolarization (ER) has been considered as a benign electrocardiographic finding. However, recent reports show that ER is associated with a higher incidence of ventricular fibrillation (VF) and sudden cardiac death in patients without structural heart disease. Sporadic case studies have pointed out that ER might be related to an adverse outcome in patients with stable coronary artery disease.
  
  
  OBJECTIVE
  To evaluate the incidence of ER in patients with acute myocardial infarction complicated by VF.
  
  
  METHODS
  The study population consisted of 60 patients (80% men; mean age 61.8 ± 13.1 years) with acute myocardial infarction. Thirty consecutive patients (80% men; mean age 63.3 ± 12 years) admitted to our hospital had documented VF during myocardial infarction and were successfully resuscitated before hospital admission. A matched control group consisted of 30 patients (80% men; mean age 60.2 ± 14.2 years) with myocardial infarction without ventricular tachyarrhythmias. Twelve-lead electrocardiograms were analyzed for ER defined as J-point elevation ≥ 0.1 mV and "notching" and "slurring" of the terminal part of the QRS complex in at least 2 lateral or inferior leads.
  
  
  RESULTS
  The ER pattern was observed in 18 of the 60 patients with acute myocardial infarction. Mean elevation of the J point was 0.151 ± 0.46 mV. Notching of the J wave was observed in 14 of the 18 patients and slurring in 4 of the 18 patients. ER was more common in patients with myocardial infarction complicated by VF than in patients with myocardial infarction without ventricular tachyarrhythmias (47% vs 13%; P = .005). There have been no statistical differences in the distribution of ER in the 12-lead electrocardiogram (inferior 39% vs lateral 33% vs inferolateral 28%; P >.05).
  
  
  CONCLUSIONS
  Early repolarization pattern seems to be associated with ventricular tachyarrhythmias in the setting of acute myocardial infarction.
authors.affiliation: Ist Department of Medicine-Cardiology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany. boris.rudic@umm.de
authors.forename: Boris
authors.initials: B
authors.lastname: Rudic
authors.forename: Christian
authors.initials: C
authors.lastname: Veltmann
authors.forename: Esther
authors.initials: E
authors.lastname: Kuntz
authors.forename: Michael
authors.initials: M
authors.lastname: Behnes
authors.forename: Elif
authors.initials: E
authors.lastname: Elmas
authors.forename: Torsten
authors.initials: T
authors.lastname: Konrad
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kuschyk
authors.forename: Christel
authors.initials: C
authors.lastname: Weiss
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.forename: Rainer
authors.initials: R
authors.lastname: Schimpf
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology*; D014693:Ventricular Fibrillation / Q000150:complications* / Q000503:physiopathology*