title: Early repolarization is associated with atrial and ventricular tachyarrhythmias in patients with acute ST elevation myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: BACKGROUND
  Recent studies found that early repolarization (ER) is significantly more common in survivors of aborted sudden cardiac death. We hypothesized that ER might be more common in patients with ST elevation myocardial infarction (STEMI) who have complications of atrial and ventricular arrhythmias.
  
  
  METHODS
  This study included 266 patients with acute STEMI undergoing primary percutaneous coronary intervention. 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. Acute and late atrial and ventricular arrhythmic events were evaluated.
  
  
  RESULTS
  The ER pattern was observed in 76 patients (28.6%). Atrial arrhythmia [21/76 (27.6%) vs. 22/190 (11.6%), p=0.001] and ventricular arrhythmia [16/76 (21.1%) vs. 16/190 (8.4%), p=0.004] were more frequently complicated in patients with ER than those without during hospitalization. ER was a significant independent predictor of developing atrial (HR=2.682, 95% CI=1.355-5.310, p=0.005) and ventricular arrhythmia (HR=2.936, 95% CI=1.360-6.335, p=0.006). Three patients with ER and ventricular fibrillation expired during hospitalization [3.9% (3/76) vs. 0% (0/190), p=0.023]. However, the presence of ER did not affect the late recurrence of atrial and ventricular arrhythmia.
  
  
  CONCLUSIONS
  The ER pattern is commonly observed in patients with STEMI and associated with atrial and ventricular tachyarrhythmia during acute setting.
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Yae Min
authors.initials: YM
authors.lastname: Park
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Woong Chol
authors.initials: WC
authors.lastname: Kang
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Soon Yong
authors.initials: SY
authors.lastname: Suh
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Kyunghoon
authors.initials: K
authors.lastname: Lee
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Mi-Seung
authors.initials: MS
authors.lastname: Shin
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Kwang Kon
authors.initials: KK
authors.lastname: Koh
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Taehoon
authors.initials: T
authors.lastname: Ahn
authors.affiliation: Cardiology Division, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea. Electronic address: cis@gilhospital.com.
authors.forename: In Suck
authors.initials: IS
authors.lastname: Choi
authors.affiliation: Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Eak Kyun
authors.initials: EK
authors.lastname: Shin
mesh_terms: D000368:Aged; D004562:Electrocardiography / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D062645:Percutaneous Coronary Intervention / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D013997:Time Factors
keywords: Atrial and ventricular arrhythmia; Early repolarization (ER); ST elevation myocardial infarction (STEMI)