title: Early Repolarization Pattern Is Associated with Increased Risk of Early Ventricular Arrhythmias during Acute ST Segment Elevation Myocardial Infarction.
abstract: BACKGROUND
  Early repolarization (ER) and acute ST segment elevation myocardial infarction (STEMI) are sharing the pathophysiology of J wave syndromes. It is speculated that early ventricular arrhythmias (VAs) during STEMI may be predisposed by ER. Our aim was to study the association between ER pattern and risk of VAs during acute STEMI.
  
  
  METHODS
  The study included 102 male patients with acute STEMI who were divided into two groups: cases and controls. Cases included 52 patients with sustained VAs during the first 48 hours from the onset of STEMI, while controls included 50 patients with no VAs. On 12-lead surface electrocardiogram, ER was defined as ≥ 1 mm elevation of J point in at least two inferior or lateral leads with or without ST segment elevation.
  
  
  RESULTS
  Mean age was 48.44 ± 10.08 years and mean left ventricular ejection fraction (LVEF) was 42.25 ± 11.1%. ER pattern was more frequent in cases than controls (29 vs 14 patients, P = 0.008). Notched J wave (P = 0.0007) and horizontal ST segment (P = 0.033) were more frequent in cases than controls. On adjusted regression model, LVEF (OR: 0.95, 95% CI: 0.91-0.99, P = 0.015) and ER (OR: 3.39, 95% CI: 1.41-8.12, P = 0.006) could predict VAs, while QTc interval (P = 0.24) and QTd (P = 0.86) did not have predictive effect. Inferior/inferolateral and global ER pattern (P = 0.044 and 0.031 respectively), notched J wave (P = 0.001), increasing J wave amplitude (P = 0.042), and ST segment elevation (P = 0.001) were associated with a higher risk of VAs.
  
  
  CONCLUSIONS
  ER is associated with increased risk of VAs in the setting of acute STEMI.
authors.affiliation: Department of Cardiology, Ain Shams University Hospital, Ain Shams University, Cairo, Egypt.
authors.forename: Osama
authors.initials: O
authors.lastname: Ali Diab
authors.affiliation: Dubai Hospital, Dubai, United Arab Emirates.
authors.forename: Ragab Mohammed
authors.initials: RM
authors.lastname: Abdel-Hafez Allam
authors.affiliation: Department of Cardiology, Ain Shams University Hospital, Ain Shams University, Cairo, Egypt.
authors.forename: Haitham Galal
authors.initials: HG
authors.lastname: Mohamed
authors.affiliation: Department of Cardiology, Ain Shams University Hospital, Ain Shams University, Cairo, Egypt.
authors.forename: Tarek Rashid
authors.initials: TR
authors.lastname: Mohamed
authors.affiliation: Department of Cardiology, Ain Shams University Hospital, Ain Shams University, Cairo, Egypt.
authors.forename: Said
authors.initials: S
authors.lastname: Abel-Hafeez Khalid
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology*; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D004562:Electrocardiography; D006329:Heart Conduction System / Q000002:abnormalities*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000209:etiology
keywords: J wave syndromes; ST segment elevation; STEMI; early repolarization; myocardial infarction; ventricular arrhythmias